Using a Low-Sodium, High-Potassium Salt Substitute to Reduce Blood Pressure among Tibetans with High Blood Pressure: A Patient-Blinded Randomized Controlled Trial

Zhao, Xingshan; Yin, Xuejun; Li, Xian; Yan, Lijing L.; Lam, Christopher T.; Li, Shenshen; He, Feng; Xie, Wuxiang; Ba, Schölkens; Gesang, Luobu; Liang, Ke; Wu, Yangfeng

doi:10.1371/journal.pone.0110131

Cited by 50 publications

(47 citation statements)

References 24 publications

(23 reference statements)

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“…Du et al 34 in the face of high salt intake and low potassium intake in Chinese adults, concluded that the substitution of sodium by potassium in salt could be efficient in reducing hypertension levels, along with other actions to prevent and control the disease. Zhao et al 35 also found similar results with Chinese over 40 years. In Brazilian elderly, it was verified that 80% of men and 61% of women had habitual excessive intake of sodium.…”

Section: Resultssupporting

confidence: 52%

Mineral Intake and Blood Pressure Control of Brazilian Elderly

Araújo¹

2017

MOJGG

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Abbreviations: NCD, chronic noncommunicable diseases;EAR, estimated average requirement; AI, adequate intake; UL, maximum tolerable upper intake level; SBP, systolic blood pressure; DBP, diastolic blood pressure IntroductionBrazil is going through a demographic transition which results in the rapid aging of the population.1,2 The Brazilian population with more than 80 years, was approximately 731,350 inhabitants in year 2000, and increased to 1,133,223 in 2010. 3 Changes due to aging make people more vulnerable to disease development, with an emphasis on chronic noncommunicable diseases (NCDs). 4 The current food pattern also contributes to the increased incidence of NCDs. The growth in the consumption of ultraprocessed foods results in a greater intake of calories, fats, sugars and sodium, nutrients closely related to diseases such as obesity and hypertension. 5Micronutrient intake among Brazilian elderly is far from the recommended values, in consequence of the low variety of foods in the diet 6 and low consumption of fruits and vegetables. 5 The Brazilian population consumes approximately a quarter of the value recommended by the Brazilian Food Guide 7 for these foods. 8 Although necessary in relatively small amounts, minerals are involved in the regulation of physiological processes, such as reproduction, immune response, metabolism and neural functions. Minerals must be obtained through food and inadequate consumption can lead to serious damage to health, increasing morbidity and mortality. High sodium intake has a correlation with NCDs, including hypertension, 10 which is one of the most prevalent diseases among the elderly.11,12 Inadequate intake of calcium and potassium may also contribute to the elevation of pressure levels.13-15 Among Brazilians aged 75 or over, the proportion of hypertensive patients is 55%. 16,17 As for iron deficiency, in addition to causing anemia, it can still lead to a decrease in cognitive abilities in the elderly. 18 Individuals with reduced cognitive abilities may have lower adherence to medications, including antihypertensive drugs. 19 The aim of this study was to investigate the consumption of minerals by very elderly hypertensive individuals, in outpatient follow-up. Materials and methodsThe study target population consisted of patients aged 80 and over who were under regular treatment at a public reference center for the treatment of hypertension. A specific questionnaire was applied for the collection of sociodemographic and lifestyle data. The dietary intake of iron, sodium, calcium and potassium was evaluated by calculating three 24-hour recall, collected on non-consecutive days, including one weekend with Dietwin software professional version. The mineral content of the diet was analyzed according to the recommendations of the Institute of Medicine (IOM). To estimate the prevalence of inadequacy in mineral consumption, the estimated average requirement (EAR) values were taken into account. 20,21 In the case of potassium, where there is no established EAR, the adequat...

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Section: Resultssupporting

confidence: 52%

Mineral Intake and Blood Pressure Control of Brazilian Elderly

Araújo¹

2017

MOJGG

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“…When people have an increased intake of potassium, high intake of sodium is not associated with higher blood pressure [21]. Recent human trials have probed the joint effects of sodium and potassium on hypertension and its cardiovascular sequelae [22,23]. In the present study, although the group of participants with the highest consumption of kimchi also had the highest sodium intake, the risk of hypertension was not different between the groups.…”

Section: Discussionmentioning

confidence: 47%

Consumption of kimchi, a salt fermented vegetable, is not associated with hypertension prevalence

Song

Lee

2014

Journal of Ethnic Foods

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a b s t r a c tBackground: The aim of this study was to investigate the association between hypertension and kimchi, a salt-fermented vegetable, intake. , and 2012. In the final analysis, a total of 20,114 Korean adults (men ¼ 7,815, women ¼ 12,299) was included. Daily energy, nutrient, and kimchi intake were assessed using 24-hour dietary recall. The odds ratios for hypertension, according to groups of quintiles of kimchi consumption by gender, were assessed using logistic regression and multivariable models. Results: Out of 20,114 participants, 11.3% were newly diagnosed as having hypertension. Although participants with higher consumption of kimchi were more likely to have an older age, higher blood pressure, and a higher BMI, as well as higher consumption of calories and sodium, there was no significant difference in the distribution of prevalence of hypertension across quintiles of kimchi consumption in men and women. In multivariate models by gender, higher consumption of kimchi was not associated with a higher prevalence of hypertension (odds ratio ¼ 0.87; 95% confidence interval ¼ 0.70 e1.08 for 216.5 g/day vs. <39.2 g/day; p for trend ¼ 0.7532, in men; odds ratio ¼ 1.04; 95% CI ¼ 0.80 e1.34 for 145.1 g/day vs. < 19.5 g/day; p for trend ¼ 0.2875, in women). Conclusion: High consumption of kimchi was not associated with an increased prevalence of hypertension in humans. Our results suggested that high potassium intake due to high consumption of kimchi may have helped neutralize the effect of elevated sodium intake on blood pressure levels.

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“…57 The blood pressure lowering effect of salt substitute has been reconfirmed in trials in patients with hypertension in other Chinese populations. 58, 59 Based on data from the China Salt Substitute Study, using a salt substitute only among those with hypertension would reduce the number of cardiovascular events by 300,000 annually, and would save hundreds millions of medical costs. 57 The evidence strongly argues for population salt reduction to be a national strategy for prevention and control of hypertension and CVD.…”

Section: Changes In Lifestylementioning

confidence: 99%

Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China

2016

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With one fifth of the world’s total population, China’s prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. To understand China’s current cardiovascular epidemic, requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The later have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the health care system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that four priorities should be taken: pursue multi-sectorial government and non-government strategies targeting the underlying causes of CVD (the “whole-of-government and whole-of-society” policy); give priority to prevention; reform the health care system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the four priorities, the pandemic of CVD and other major NCDs in China will be reversed and the global sustainable development goal achieved.

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Using a Low-Sodium, High-Potassium Salt Substitute to Reduce Blood Pressure among Tibetans with High Blood Pressure: A Patient-Blinded Randomized Controlled Trial

Cited by 50 publications

References 24 publications

Mineral Intake and Blood Pressure Control of Brazilian Elderly

Mineral Intake and Blood Pressure Control of Brazilian Elderly

Consumption of kimchi, a salt fermented vegetable, is not associated with hypertension prevalence

Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China

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