The George Institute for Global Health (J.Y., C.A., Q.L., G.L.D.T., L.H., X.Y., B.N.), University of New South Wales, Sydney, Australia.
Faculty of Medicine (J.Y., C.A.), University of New South Wales, Sydney, Australia.
Hypertension. 2024 May;81(5):1031-1040. doi: 10.1161/HYPERTENSIONAHA.123.22410. Epub 2024 Mar 11.
The SSaSS (Salt Substitute and Stroke Study) has shown that use of a potassium-enriched salt lowers the risk of stroke, total cardiovascular events, and premature death. The effects on cause-specific cardiac outcomes are reported here.
SSaSS was an unblinded, cluster-randomised trial assessing the effects of potassium-enriched salt compared with regular salt among 20 995 Chinese adults with established stroke and older age and uncontrolled hypertension. Post hoc efficacy analyses were performed using an intention-to-treat method and a hierarchical Poisson regression model adjusting for clustering to obtain rate ratios and 95% CIs. We assessed acute coronary syndrome, heart failure, arrhythmia, and sudden death.
Over a mean 4.74 years follow-up, there were 695 acute coronary syndrome events, 454 heart failure events, 230 arrhythmia events, and 1133 sudden deaths recorded. The rates of events were lower in potassium-enriched salt group for all outcomes but CIs were wide for most: acute coronary syndrome (6.32 versus 7.65 events per 1000 person-years; rate ratio, 0.80 [95% CI, 0.65-0.99]); heart failure (9.14 versus 11.32 events per 1000 person-years; rate ratio, 0.88 [95% CI, 0.60-1.28]); arrhythmia (4.43 versus 6.20 events per 1000 person-years; rate ratio, 0.59 [95% CI, 0.35-0.98]); and sudden death (11.01 versus 11.76 events per 1000 person-years; rate ratio, 0.94 [95% CI, 0.82-1.07]; all >0.05 with adjustment for multiple comparisons).
These results suggest that use of potassium-enriched salt is more likely to prevent than cause cardiac disease but the post hoc nature of these analyses precludes definitive conclusions.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02092090.
SSaSS（盐替代和中风研究）表明，使用富含钾的盐可降低中风、全心血管事件和过早死亡的风险。本文报告了其对特定病因心脏结局的影响。
SSaSS 是一项非盲、集群随机试验，评估了富含钾的盐与普通盐相比在 20995 名患有已确诊中风和年龄较大且未控制的高血压的中国成年人中的效果。使用意向治疗方法和分层泊松回归模型进行事后疗效分析，调整聚类以获得率比和 95%CI。我们评估了急性冠状动脉综合征、心力衰竭、心律失常和猝死。
在平均 4.74 年的随访中，记录了 695 例急性冠状动脉综合征事件、454 例心力衰竭事件、230 例心律失常事件和 1133 例猝死事件。富含钾盐组的所有结局的事件发生率均较低，但大多数 CI 较宽：急性冠状动脉综合征（每 1000 人年 6.32 与 7.65 例；率比，0.80 [95%CI，0.65-0.99]）；心力衰竭（每 1000 人年 9.14 与 11.32 例；率比，0.88 [95%CI，0.60-1.28]）；心律失常（每 1000 人年 4.43 与 6.20 例；率比，0.59 [95%CI，0.35-0.98]）；猝死（每 1000 人年 11.01 与 11.76 例；率比，0.94 [95%CI，0.82-1.07]）；所有比较均>0.05，调整了多重比较。
这些结果表明，使用富含钾的盐更可能预防而不是导致心脏病，但这些事后分析的性质排除了明确的结论。
