Li Xiaoxia, Huang Liping, Zhou Bo, Li Zhifang, Sun Jixin, Yu Yan, Song Hongyi, Tian Maoyi, Yin Xuejun, Neal Bruce, Zhang Yuhong, Wu Yangfeng, Zhao Yi
School of Public Health, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, China.
Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China.
Eur J Epidemiol. 2025 Mar 27. doi: 10.1007/s10654-025-01216-x.
The effect of a potassium-enriched salt substitute on cumulative blood pressure (BP) remains unclear. This study aimed to assess the long-term effects of a potassium-enriched salt substitute versus regular salt on cumulative and conventional measures of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP). We analyzed data from the Salt Substitute and Stroke Study (SSaSS), a 5-year cluster randomized controlled trial in rural of China with 20,995 participants. The intervention used salt substitute; controls used regular salt. BP was measured for all participants at baseline, among subsamples at 12-month intervals, and for all alive at 60 months. Cumulative BP was calculated as the average between baseline and follow-up measures multiplied by the time between them (mmHg × year). Linear mixed models were used to assess the effects of salt substitution on BP outcomes at each follow-up visit. After a mean 4.74 years of follow-up, salt substitute compared to the regular salt lowered the cumulative SBP with a mean (SD) of 740 (85) vs. 750 (87) mmHg×year. Salt substitute also lowered cumulative MAP and PP, with means (SD) of 560 (58) vs. 566 (59) mmHg×year, and 306 (67) vs. 313 (68) mmHg×year, respectively. Similar beneficial effects of the salt substitute were observed for traditional measurements of SBP, MAP, and PP. There was no difference in either cumulative DBP (434 vs. 437 mmHg × year) or traditional DBP (85 vs. 86 mmHg). Salt substitute significantly reduced cumulative and traditional SBP, MAP, and PP, but not DBP. TRIAL REGISTRATION: SSaSS ClinicalTrials.gov number: NCT0 2,092,090.
富含钾的盐替代品对累积血压（BP）的影响尚不清楚。本研究旨在评估富含钾的盐替代品与普通盐相比，对收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和脉压（PP）的累积及常规测量指标的长期影响。我们分析了“盐替代品与中风研究”（SSaSS）的数据，这是一项在中国农村地区进行的为期5年的整群随机对照试验，有20995名参与者。干预组使用盐替代品；对照组使用普通盐。在基线时对所有参与者测量血压，在子样本中每隔12个月测量一次，并在60个月时对所有存活者测量血压。累积血压计算为基线和随访测量值之间的平均值乘以两者之间的时间（mmHg×年）。使用线性混合模型评估每次随访时盐替代对血压结果的影响。经过平均4.74年的随访，与普通盐相比，盐替代品降低了累积SBP，平均值（标准差）分别为740（85）与750（87）mmHg×年。盐替代品还降低了累积MAP和PP，平均值（标准差）分别为560（58）与566（59）mmHg×年，以及306（67）与313（68）mmHg×年。对于SBP、MAP和PP的传统测量指标，也观察到了盐替代品的类似有益效果。累积DBP（434与437mmHg×年）或传统DBP（85与86mmHg）均无差异。盐替代品显著降低了累积及传统的SBP、MAP和PP，但未降低DBP。试验注册：SSaSS ClinicalTrials.gov编号：NCT0 2,092,090。
