Researchers believe that the positive impacts are likely to apply to people all over the world.

High blood pressure is a significant risk factor for early death, and heart disease is the leading cause of mortality worldwide. Blood pressure is known to increase with a diet that is high in sodium and low in potassium.

A pooled data analysis of the available evidence, published online in the journal Heart, reveals that dietary salt alternatives reduce the risk of heart attack, stroke, death from all causes, and cardiovascular disease.

According to the experts, individuals all across the world are expected to benefit from these substitutes.

High blood pressure is a significant risk factor for an early death, and cardiovascular disease is the leading cause of mortality worldwide. Blood pressure is known to increase with a diet that is high in sodium and low in potassium.

According to the study, 1.28 billion people worldwide have excessive blood pressure, yet more than half of these cases go untreated.

Blood pressure is known to be lowered by salt replacements, which contain a fraction of potassium chloride (KCl) instead of sodium chloride (NaCl).

Salt replacements reduce the incidence of heart attacks, strokes, and early mortality, according to a recent big study from China (Salt Substitute and Stroke Study; SSaSS), but it was unclear whether these advantages would extend to other regions of the world.

In order to shed light on this, the researchers combed through research databases for randomised clinical trials published up to the end of August 2021 that reported on the effects of a salt substitute on blood pressure, cardiovascular health, and premature death.

The two numbers that makeup blood pressure, which is expressed in millimeters of mercury (mmHg), are the systolic (higher number), which represents the force with which the heart pumps blood throughout the body, and the diastolic (lower number), which represents arterial pressure when the heart is filling with blood.

They combined the findings of 21 major international clinical trials that involved close to 30,000 participants and were conducted in the Western Pacific, the Americas, South-East Asia, and Europe.

The research periods ranged from one month to five years. The salt substitutes’ sodium chloride content ranged from 33 to 75 percent, while their potassium content ranged from 25 to 65 percent.

The analysis of pooled data revealed that salt substitutes reduced blood pressure in all participants. Systolic blood pressure decreased generally by 4.61 mm Hg, while diastolic blood pressure decreased overall by 1.61 mm Hg.

No of the location, age, sex, history of high blood pressure, weight (BMI), baseline blood pressure, or baseline sodium and potassium levels in the urine, blood pressure reductions appeared to be consistent across all of these variables.

Additionally, a 1.53 mmHg greater reduction in systolic blood pressure and a 0.95 mmHg bigger fall in diastolic blood pressure were linked to each 10% lower proportion of sodium chloride in the salt alternative. There was no proof that consuming more potassium in your diet would be bad for your health.

A pooled data analysis of the outcomes of five of these trials involving over 24,000 individuals found that salt substitutes reduced the odds of premature mortality from any cause by 11%, cardiovascular disease by 13%, and heart attack or stroke by 11%.

The studies in the pooled data analysis differed in their study designs, and there were comparatively limited data for those without high blood pressure, which the researchers accept as limitations of their findings.

However, they point out that their results concur with those of the SSaSS, the largest-ever study to date of a potassium-enriched salt alternative.

The authors write that because salt substitutes’ ability to lower blood pressure is the mechanism by which they provide cardiovascular protection, “the observed consistent blood pressure reductions make a strong case for the cardiovascular protective effect observed in the SSaSS both outside of China and beyond.”

These findings support the use of salt substitutes in clinical practice and public health policy as a method for lowering dietary sodium intake, enhancing dietary potassium intake, lowering blood pressure, and preventing major cardiovascular events, they write.

“These findings are unlikely to reflect the play of chance,” they conclude.

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