Few folks with hypertension have been utilizing salt substitutes, though they’re a easy and efficient solution to decrease sodium consumption and handle blood stress, in accordance with preliminary analysis introduced on the American Coronary heart Affiliation’s Hypertension Scientific Classes 2025. The assembly is the premier scientific trade targeted on current advances in fundamental and scientific analysis on hypertension and its relationship to cardiac and kidney illness, stroke, weight problems and genetics.
Hypertension happens when the drive of blood flowing via the blood vessels is persistently too excessive. Hypertension can result in different severe occasions reminiscent of coronary heart assault and stroke. Utilizing information from 2017 to 2020, 122.4 million (46.7%) adults within the U.S. had hypertension and it contributed to greater than 130,000 deaths. An excessive amount of sodium and too little potassium within the weight-reduction plan are threat elements for hypertension.
“Total, lower than 6% of all U.S. adults use salt substitutes, though they’re cheap and might be an efficient technique to assist folks management blood stress, particularly folks with difficult-to-treat hypertension,” mentioned lead research creator Yinying Wei, M.C.N., R.D.N., L.D., and Ph.D. candidate within the departments of utilized scientific analysis and hypertension part, cardiology division, at UT Southwestern Medical Heart in Dallas. “Well being care professionals can increase consciousness concerning the secure use of salt substitutes by having conversations with their sufferers who’ve persistent or hard-to-manage hypertension.”
Salt substitutes are merchandise that substitute some or the entire sodium with potassium. Potassium salt tastes much like common salt, besides when heated it will possibly have a bitter aftertaste. Many meals include some sodium of their pure state, nonetheless, the most important quantity of sodium comes from processed and packaged meals and meals ready at eating places. The American Coronary heart Affiliation recommends consuming not more than 2,300 mg of sodium a day, with a super restrict of lower than 1,500 mg per day for many adults, particularly for these with hypertension. For most individuals, chopping again by 1,000 mg a day can enhance blood stress and coronary heart well being.
This research is the primary to look at long-term developments in salt substitute use amongst a nationally consultant pattern of U.S. adults. Utilizing information from the Nationwide Well being and Diet Examination Survey (NHANES) from 2003 to 2020, researchers analyzed the usage of merchandise that substitute salt with potassium-enriched or different different salts.
The investigation targeted on folks with hypertension, and an extra evaluation was performed amongst adults eligible to make use of salt substitutes, together with folks with regular kidney operate and people not taking medicines or dietary supplements that have an effect on blood potassium ranges. Some salt substitutes include potassium, they usually can increase blood potassium to harmful ranges in folks with kidney illness or these taking sure medicines or potassium dietary supplements. Extreme potassium can result in irregular coronary heart rhythms. Folks with hypertension who’re occupied with switching from common salt to a salt substitute ought to first seek the advice of with a well being care skilled.
The evaluation discovered:
- Total, salt substitute use amongst all U.S. adults remained low, peaking at 5.4% in 2013-2014 earlier than falling to 2.5% by 2017-March 2020. Knowledge assortment for 2020 stopped earlier than March due to the pandemic.
- Amongst adults eligible to make use of salt substitutes, solely 2.3% to five.1% did so.
- Utilization was highest in folks with hypertension whose BP was managed with medicines (3.6%-10.5%), adopted by these with hypertension whose BP was not managed regardless of medicines (3.7%-7.4%).
- Salt substitute use remained persistently lower than 5.6% amongst folks with untreated hypertension and for folks with regular blood stress.
- Adults who ate at eating places three or extra occasions per week appeared much less possible to make use of salt substitutes in comparison with those that ate out much less typically, however this distinction was now not statistically vital after accounting for age, race/ethnicity, training degree and insurance coverage standing.
“Salt substitute use remained unusual during the last 20 years together with amongst folks with hypertension,” Wei mentioned. “Even amongst people with handled and poorly managed or untreated hypertension, most continued to make use of common salt.”
“This research highlights an essential and simple missed alternative to enhance blood stress within the U.S. — the usage of salt substitutes,” mentioned Amit Khera, M.D., M.Sc., FAHA, an American Coronary heart Affiliation volunteer knowledgeable. “The truth that use of salt substitutes stays so low and has not improved in 20 years is eye-opening and reminds sufferers and well being care professionals to debate the usage of these substitutes, significantly in visits targeted on hypertension.” Khera, who was not concerned on this research, is a professor of drugs, scientific chief of cardiology and director of preventive cardiology at UT Southwestern Medical Heart in Dallas.
The research has a number of limitations. First, details about salt substitute use was self-reported, so there could have been underreporting or misclassification. As well as, all sorts of salt substitutes have been included within the evaluation, subsequently, the evaluation couldn’t particularly separate potassium-enriched salt from different sorts of salt substitutes. Lastly, the survey information didn’t seize how a lot salt substitute the members used.
“Future analysis ought to discover why salt substitute-use stays low by investigating potential limitations, reminiscent of style acceptance, price and restricted consciousness amongst each sufferers and clinicians,” mentioned Wei. “These insights could assist information extra focused interventions.”
Examine particulars, background and design:
- The evaluation included 37,080 adults, ages 18 and older (37.9% have been aged 18-39, 36.9% have been aged 40-59 years, and 25.2% have been aged 60 and older). 50.6% of members have been ladies, 10.7% of members self-reported their race as non-Hispanic Black, and 89.3% self-reported they have been from different racial and ethnic teams.
- Contributors have been categorized into 4 subgroups primarily based on presence or absence of hypertension (≥130/80 mm Hg) and whether or not they have been utilizing blood stress reducing remedy: 1) hypertension that was handled and managed; 2) hypertension that was handled and never managed; 3) untreated hypertension; and 4) these with regular blood stress.
- Salt sorts have been categorized as unusual salt (iodized salt, sea salt, kosher salt), salt substitute (potassium-enriched or different salt substitute) and no salt use.
- A further evaluation was performed on a subgroup of people eligible to make use of salt substitutes — these with wholesome kidney operate (estimated glomerular filtration price ≥ 60) and never taking medicines or dietary supplements that have an effect on blood potassium ranges.
- The frequency of consuming at eating places to evaluate its affect on salt substitute use was additionally evaluated.
- All analyses integrated NHANES sampling weights and complicated survey design.
Analysis Highlights:
- Regardless of their effectiveness in reducing sodium consumption and managing blood stress, salt substitutes have been hardly ever utilized by folks with hypertension, in accordance with a overview of virtually 20 years of U.S. well being survey information.
- Researchers advocate growing consciousness of salt substitutes as a method to assist successfully deal with blood stress, particularly for people with difficult-to-treat or treatment-resistant hypertension.
- The research is supported by a grant from the Nationwide Institutes of Well being.
- Observe: The research featured on this information launch is a analysis summary. Abstracts introduced at American Coronary heart Affiliation‘s scientific conferences will not be peer-reviewed, and the findings are thought-about preliminary till revealed as a full manuscript in a peer-reviewed scientific journal.
