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Effect of salt substitution on community-wide blood pressure and hypertension incidence

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dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Sal Y Rosas, Víctor G.
dc.contributor.author Ponce-Lucero, Vilarmina
dc.contributor.author Cárdenas García-Santillán, María Kathia
dc.contributor.author Carrillo Larco, Rodrigo Martín
dc.contributor.author Diez-Canseco Montero, Francisco
dc.contributor.author Pesantes Villa, María Amalia
dc.contributor.author Sacksteder, Katherine A.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Miranda, J. Jaime
dc.date.accessioned 2020-07-14T00:00:57Z
dc.date.available 2020-07-14T00:00:57Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/8234
dc.description.abstract Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (-2.17, -0.41)) in systolic and 0.76 mm Hg (95% CI (-1.39, -0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, -0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence. en_US
dc.language.iso eng
dc.publisher Springer Nature
dc.relation.ispartofseries Nature Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Peru/epidemiology en_US
dc.subject Surveys and Questionnaires en_US
dc.subject Follow-Up Studies en_US
dc.subject Residence Characteristics en_US
dc.subject Blood Pressure/drug effects en_US
dc.subject Case-Control Studies en_US
dc.subject Diastole en_US
dc.subject Hypertension/epidemiology/physiopathology/urine en_US
dc.subject Incidence en_US
dc.subject Potassium/urine en_US
dc.subject Sodium Chloride, Dietary/adverse effects en_US
dc.subject Sodium/urine en_US
dc.subject Systole en_US
dc.title Effect of salt substitution on community-wide blood pressure and hypertension incidence en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1038/s41591-020-0754-2
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.03
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.00.00
dc.relation.issn 1546-170X


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