Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, Beijing, China.
State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
J Evid Based Med. 2024 Jun;17(2):454-467. doi: 10.1111/jebm.12621. Epub 2024 Jun 24.
Both excessive intake of sodium and inadequate intake of potassium are associated with blood pressure elevation and subsequent increase in the risk of cardiovascular disease, which accounts for the largest number of deaths in China and worldwide. Low sodium salt, a mixture of mainly sodium chloride and potassium chloride, has shown its great potential as a promising population strategy for sodium intake reduction through multiple large-scale, multicenter, randomized controlled trials among populations including patients with cardiovascular disease, individuals with and without hypertension, older and younger adults, and men and women in China and other countries. This Guidelines aims to provide expert recommendations for promotion and use of low sodium salt in China, based on the current available scientific evidence regarding the effectiveness, safety, cost-effectiveness, and acceptability of low sodium salts in various population groups and different application scenarios. The suggestions to key stakeholders are also made.
A working group, an expert review committee and an advisory committee were established to be responsible for formulating the guidelines' scope and key questions to be addressed, for searching, synthesizing, and evaluating research evidence, proposing and reviewing the recommendations. The consensus on the final recommendations was reached using the GRADE grid method.
The working group summarized current available evidence of salt substitution regarding its effectiveness, safety, cost-effectiveness, acceptability, availability, suitability, etc. The Guidelines provided six recommendations advising different populations how to use low sodium salt, four recommendations on the application of low sodium salts in different scenarios, and five suggestions for key stakeholders to promote salt substitution.
The first evidence-based guidelines on promotion and use of low sodium salts covers all key questions in relevance and would play a critical role in prevention and control of hypertension and cardiovascular disease in China and worldwide.
摄入过多的钠和摄入不足的钾都与血压升高以及随后心血管疾病风险的增加有关，这在中国乃至全球范围内导致了数量最多的死亡。低钠盐，主要由氯化钠和氯化钾组成的混合物，已通过在中国和其他国家的包括心血管疾病患者、有和没有高血压的个体、老年人和年轻人以及男性和女性在内的人群中的多项大规模、多中心、随机对照试验，显示出作为一种有前途的人群减少钠摄入量的策略的巨大潜力。本指南旨在根据目前关于低钠盐在不同人群和不同应用场景中的有效性、安全性、成本效益和可接受性的现有科学证据，为在中国推广和使用低钠盐提供专家建议。还向主要利益相关者提出了建议。
成立了一个工作组、一个专家审查委员会和一个顾问委员会，负责制定指南的范围和要解决的关键问题，负责搜索、综合和评估研究证据，提出和审查建议。使用 GRADE 网格方法对最终建议达成共识。
工作组总结了目前关于盐替代的有效性、安全性、成本效益、可接受性、可用性、适用性等方面的现有证据。本指南就不同人群如何使用低钠盐提出了六项建议，就低钠盐在不同场景中的应用提出了四项建议，并就推广盐替代向主要利益相关者提出了五项建议。
这是关于推广和使用低钠盐的首份基于证据的指南，涵盖了所有相关的关键问题，将在中国乃至全球范围内对高血压和心血管疾病的预防和控制发挥关键作用。
