Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial - Nature Medicine

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Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial - Nature Medicine
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In a cluster-randomized trial in 48 residential elderly care facilities in China, a low-sodium salt substitute instead of regular salt decreased blood pressure and cardiovascular events, while restricting salt consumption did not show beneficial effects

. Briefly, it was a cluster-randomized, factorial trial that aimed to assess the effects of two salt reduction strategies: salt substitute and a stepwise reduction in salt supply. The rationale for using a cluster design was due mainly to the convenience to implement the interventions at cluster level but the effectiveness should be evaluated at individual level.

Facilities assigned to the salt substitute group received salt substitute to replace usual salt. The salt substitute, manufactured by the China Salt General Company at Yulin in China, comprised 62.5% sodium chloride, 25% potassium chloride, 12.5% dried food ingredient flavorings and traces of amino acids. Facilities in the control group received usual salt, 100% sodium chloride, from the same company.

The study salt supply to the kitchens in facilities that were allocated to the restricted supply group was reduced step by step, with the goal of achieving a facility-wide reduction of salt supply by 40% by the end of the intervention

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