A new study by researchers from Wuhan University in China suggests that a simple dietary change (switching from regular salt to a salt substitute) can significantly lower the risk of stroke recurrence and death among patients with a history of stroke.
The study led by Xiong Ding, MPH, evaluated 15,249 patients who had experienced a stroke. Participants were assigned to either a salt substitute (composed of 75% sodium chloride and 25% potassium chloride by mass) or regular salt. Over a median follow-up period of 61.2 months, researchers found compelling results:
- The rate of recurrent stroke was significantly lower in the salt substitute group compared to the regular salt group (rate ratio, 0.86).
- Haemorrhagic stroke occurrences dropped by an even more substantial 30%.
- Death rates in the salt substitute group were lower (rate ratio, 0.88), with stroke-related deaths reduced by 21%.
- Importantly, there was no significant increase in hyperkalemia (a condition associated with high potassium levels).
Why Does Potassium-Enriched Salt Work?
The idea behind salt substitution is simple: replacing a portion of sodium with potassium helps regulate blood pressure (a key risk factor for stroke and cardiovascular disease). While excessive sodium intake has long been associated with hypertension and cardiovascular complications, potassium plays a counterbalancing role by promoting vasodilation and reducing blood pressure.
Says Dr. Aravind Badiger, Technical Director at BDR Pharmaceuticals:
“Potassium-enriched salt is a modified version of regular table salt (sodium chloride) in which a portion of sodium is replaced with potassium. This alteration provides a dual benefit: reducing sodium intake while increasing potassium levels, both of which are essential for maintaining cardiovascular health.”
From a pharmaceutical standpoint, stroke prevention strategies often rely on antihypertensive medications, anticoagulants, and lipid-lowering drugs. However, adherence to these treatments can be challenging due to factors such as side effects, cost, and patient compliance.
“Introducing potassium-enriched salt as an adjunct dietary measure offers a cost-effective, non-pharmacological approach to managing blood pressure and reducing stroke recurrence risk,” says Dr. Badiger.
How To Make the Switch To Potassium-Enriched Salt
For those interested in making the transition, here are a few practical steps:
- Gradual Replacement: Instead of making an abrupt switch, gradually incorporate potassium-enriched salt into your diet.
- Read Labels: Look for products labeled “low-sodium salt” or “potassium-enriched salt” to ensure you're getting the right balance.
- Increase Fresh Foods: Complement salt substitution with a diet rich in fruits and vegetables, which are naturally high in potassium.
- Monitor Blood Pressure: Regularly check your blood pressure to assess the impact of dietary changes.
What This Means On A Broad Scale
Stroke is a leading cause of disability and death worldwide, particularly in ageing populations. In many low- and middle-income countries, where access to advanced medical treatment remains limited, dietary interventions such as salt substitution could serve as a highly accessible and scalable solution.
Countries like Finland have already implemented sodium reduction policies with potassium-enriched salt, leading to a substantial decrease in cardiovascular disease rates over time. The Wuhan University study strengthens the case for adopting similar measures globally.
Potential Concerns
One of the primary concerns surrounding potassium-enriched salt is the risk of hyperkalemia, particularly for patients with chronic kidney disease (CKD) or those taking certain medications that affect potassium levels. However, the Wuhan study found no significant increase in hyperkalemia among participants consuming the salt substitute.
Nevertheless, public health experts recommend that those with kidney disease consult their doctors before making dietary changes. For the general population, however, potassium-enriched salt appears to be a safe and effective alternative.
References:
- https://jamanetwork.com/journals/jamacardiology/article-abstract/2829790
- https://pubmed.ncbi.nlm.nih.gov/38465623/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8057138/
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