Mixed
Nationwide substitution of regular discretionary salt with potassium-enriched salt substitutes (20-30% KCl) in China yields a substantial net reduction in cardiovascular disease mortality by lowering systolic blood pressure, even when accounting for the increased risk of hyperkalemia in individuals with chronic kidney disease.
Replace your regular table salt and cooking salt with a potassium-enriched salt substitute (containing 20-30% potassium chloride). Use it in the same amounts you currently use regular salt, but try to use it slightly more sparingly if possible. This change lowers blood pressure and significantly reduces the risk of heart disease and stroke for the general population. If you have advanced kidney disease, consult your doctor, but note that even for kidney patients, the cardiovascular benefits of this switch generally outweigh the risks of potassium toxicity.
Nationwide implementation of potassium-enriched salt substitution could prevent approximately 461,000 (95% uncertainty interval: 196,339 to 704,438) CVD deaths/year... The net effect would be approximately 450,000 (183,699 to 697,084) fewer CVD deaths/year in the overall population, and 21,000 (1,928 to 42,926) fewer CVD deaths/year in the CKD population.
Why this rating
Based on a large-scale pragmatic trial (SSaSS) and comparative risk assessment modeling, though it is a model rather than a direct long-term clinical outcome trial.
Source
Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study
Matti Marklund et al. · BMJ · 2020
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