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| Turkish Society of Cardiology Young Cardiologists Bulletin Year: 4 Number: 2 / 2021 |
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Reviewer: Dr Sedat Kalkan Name of the Study: Effect of Salt Substitution on Cardiovascular Events and Death Published Congress: ESC 2021 Objective: It is known that the use of salt with low sodium content instead of normal salt use reduces blood pressure. In this study, the cardiovascular safety and efficacy results of salt replacement were evaluated. Method: The study, which was designed as open-ended, cluster randomization, included 20,995 people (mean age 65.4, 49.5% female) from rural China. In the 600-village study, participants were recruited from hypertensive patients aged over 60 years old or with a history of stroke. Villages were randomized 1:1 as salt exchange (75% sodium chloride, 25% potassium chloride) or continued use of normal salt (100% sodium chloride). In the study, with a mean follow-up of 4.7 years, the safety point was determined as clinical hyperkalemia, the primary endpoint was stroke, and the secondary endpoint was major cardiovascular events or death from any cause. Results: Stroke history was detected in 72.6% of the participants, and HT was detected in 88.4%. Stroke with salt exchange (29.14 events vs. 33.65 events per 1000 person/year; odds ratio, 0.86; 95% confidence interval [CI], 0.77 to 0.96; P=0.006), major cardiovascular events (49.09 versus 56.29 events per 1000 person-years; odds ratio, 0.87; 95% CI, 0.80 to 0.94; P<0.001), and death (39.28 versus 44.61 event rate 1,000 person-years 0.88; 95%CI, 0.82 to 0.95; P<0.001) was lower than using normal salt. There was no significant difference between the groups in adverse events due to hyperkalemia. (3.35 events versus 3.30 events per 1000 person-years; ratio ratio, 1.04; 95% CI, 0.80 to 1.37; P=0.76 ) Conclusion: Persons who had a history of stroke or were 60 years of age or older and had high blood pressure; the incidence of stroke, major cardiovascular events and death was lower in the low sodium salt exchange group than in the group that continued normal salt use. Interpretation : The publication of a study showing the importance of using salt with low sodium content, especially in patients with heart failure and patients with coronary artery disease, has created an warning that will come front of the warning to reduce only salt to patients
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