农村社区人群低钠盐干预后血压及尿钠和尿钾变化的随访观察

目的研究农村社区居民接受低钠富钾替代盐干预后血压的变化情况,为制定高血压防控措施提供依据。方法于2010年,整群抽取山东省莱芜市开展低钠盐干预研究中2个农村社区的农村居民共350例作为研究对象,对其进行为期3个月的低钠盐干预,干预结束后维持简单的健康教育内容。研究对象年龄30~60岁,分为高血压组167例和非高血压组183例。在干预前、干预3个月后、干预结束1年后进行随访,观察血压及24 h尿钠、尿钾的变化。结果低钠盐干预结束1年后,高血压组收缩压（SBP）相对于基线调查时下降了5.4mmHg,差异有统计学意义（t=4.451,P〈0.01）,但是,相对于低钠盐干预3个月结束时上升了2.1 mmHg,差异有统计学意义（t=2.194,P〈0.05）;非高血压组SBP变化差异无统计学意义（P〉0.05）。低钠盐干预结束1年后随访时24 h尿钾相对于基线调查时,高血压组上升了7.8 mmol/24 h,非高血压组则相对基线调查时上升了6.8 mmol/24 h,差异均有统计学意义（P〈0.01）;高血压组研究对象的钠钾比值相对于基线调查和低钠盐干预3个月结束时分别下降了2.3和1.0,非高血压组则分别下降了1.7和1.0,差异均有统计学意义（P〈0.01,P〈0.05）。结论单纯的健康教育所产生的降血压效果低于低钠盐干预所产生的降血压作用。     

莱芜市莱城区居民膳食钠摄入和排出调查分析

目的分析莱芜市莱城区居民膳食钠摄入和排出及其与性别、年龄、文化程度和经济状况的关系。方法 2011年6月,以18~69岁常驻居民83人为研究对象,以连续72 h膳食回顾和调味品称重相结合的方法获取膳食钠摄入数据。按标准留取24 h尿标本,检测尿钾、尿钠含量和尿钠钾比值。计量资料采用t检验,多组间比较采用单因素方差分析,变量不服从正态分布时采用秩和检验,采用Pearson双变量进行相关性分析,变量非正态分布时采用Spearman非参数检验,P0.05为差异有统计学意义。结果研究对象平均每标准人日摄入钠(6 318.73±2 660.98)mg,男性膳食钠(盐)摄入量高于女性,差异无统计学意义(t=1.121,P0.05);不同年龄组摄入量差异无统计学意义(F=2.965,P0.05);文化程度在大专及以上居民钠(盐)摄入量远低于其他两组,且与初中或高中文化程度居民摄入量的差异有统计学意义(P0.05);不同经济状况居民钠(盐)摄入量差异有统计学意义(F=4.904,P0.05)。18~69岁居民24 h尿钠均值为(234.33±69.16)mmol,24 h尿钾均值为(32.17±21.71)mmol,钠钾比均值为9.15±4.39。24 h尿钠男性高于女性,差异无统计学意义(t=1.929,P0.05);24 h尿钾男性低于女性,差异无统计学意义(t=0.192,P0.05);24 h尿钠钾比男性低于女性,差异无统计学意义(t=0.030,P0.05);不同年龄组间24 h尿钠水平差异有统计学意义(F=5.868,P0.05);各年龄组不同性别24 h尿钠、尿钾的差异均无统计学意义(P0.05)。文化程度在大专及以上居民24 h尿钠、24 h尿钾、钠钾比低于其他两组,差异均无统计学意义(F=1.864、0.135、0.812,均P0.05)。不同经济状况居民24 h尿钠、24 h尿钾、钠钾比差异均无统计学意义(F=0.287、0.487、0.294,均P0.05)。居民膳食钠与24 h尿钠呈正相关(r=0.228,P0.05),膳食钠与24 h尿钾不相关(r=0.079,P0.05)。结论莱芜市莱城区居民膳食钠摄入量较高,钾摄入量不足,调味品是钠的主要来源。年龄、文化程度和经济状况是膳食钠的摄入量和24 h尿钠钾的影响因素。     

小学生健康教育后小学生及家长尿钠、尿钾的变化

目的了解基于小学生减盐健康教育能否降低其自身及其家长盐的摄入量。方法从长治市城区28所学校即将升入5年级的班级中随机抽取1个班,随机分为干预组和对照组,每班符合条件的学生中随机抽取10名,干预组进行减盐健康教育并传递给家长。对2组学生和家长进行健康教育前后的随访,观察24 h尿钠、尿钾变化。结果健康教育后,家长24 h尿钠对照组较之前增加了(15.30±72.91)mmol,干预组较之前降低了(35.03±73.60)mmol,差异有统计学意义(t=7.726,P0.05);家长尿钠钾比值对照组较之前增加了(0.28±2.06),干预组较之前降低了(1.28±2.49),差异有统计学意义(t=6.435,P0.05);学生24 h尿钠对照组较之前增加了(11.12±27.47)mmol,干预组较之前降低了(8.43±24.16)mmol,差异有统计学意义(t=6.212,P0.05);学生尿钠钾比值对照组较之前增加了(2.73±1.87),干预组较之前增加了(2.18±2.49),差异有统计学意义(t=2.028,P0.05);结论采取对小学生进行减盐健康教育能有效促进家庭自觉减盐。     

钠钾盐饮食干预对血压的影响及补钾降低血压的机制初探

目的 通过钠钾盐饮食干预,观察其对受试者血压、血肌酐、血一氧化氮(NO)的影响,并初步探讨补钾降低血压的作用机制.方法 选择175例年龄在16～87岁、血压正常[＜140/90mm Hg(1 mm Hg=0.133 kPa)]或血压轻度偏高者(＜160/105 mm Hg)参与为期3周的盐负荷及补钾试验,包括基线调查3d,低盐饮食、高盐饮食和高盐补钾饮食各7d.各个阶段测量受试者体重、血压,并收集其血、尿标本.结果 受试者高盐阶段体重[(64.04±10.80)kg]明显高于低盐阶段[(62.88±10.10)kg](P＜0.01);高盐阶段收缩压[(116.4±10.8)mm Hg]明显高于低盐阶段[(108.8±13.1)mm Hg](P＜0.01);高盐补钾阶段血NO[(127.0±17.1)μmol/L]明显高于高盐阶段[(105.7±16.8)μmol/L](P＜0.01).结论 降低血容量是低盐饮食降低血压重要原因之一;而扩血管因子NO水平升高可能在高盐补钾阶段降低血压的机制中起到重要作用.     

昆明某高校学生尿液钠钾水平与膳食摄入相关性分析

探讨昆明某高校在校生膳食钠钾摄入比值与随机尿钠钾排泄比值和24h尿钠钾排泄比值之间的相关性,为学生的膳食营养指导提供参考.方法 选取符合纳入标准的12名昆明某高校在校大学生(男、女各半)作为受试者,将其随机平均分入4 g/d、8 g/d、12 g/d等3个不同摄盐组(每组2男2女);为其统一提供4d膳食,称重计算其每日膳食钠、钾摄入总量,收集并测定研究对象3d内随机尿钠、尿钾含量和24 h尿钠、尿钾排泄总量.结果 对3个不同摄盐组的膳食钠钾比值作秩和检验,3组间差异有统计学意义(F=7.731,P=0.021).对3个不同摄盐组的24h尿钠钾比值做方差分析,3个组间差异有统计学意义(F=7.982,P=0.01),符合分组要求.膳食钠钾比值与3d上午随机尿钠钾比值之间有正相关关系(r值分别为0.625,0.635,0.608,P值均<0.05);膳食钠钾比值与24 h尿钠钾比值之间呈正相关(r=0.642,P=0.024).结论 通过测定在校大学生上午的随机尿钠钾排泄比值或者24 h尿钠钾排泄比值对判定膳食钠钾摄入比值有一定参考价值.     

安徽省心血管病患病风险人群社区公共卫生综合干预对血压水平控制效果分析

  目的  分析不同心血管疾病(cardiovascular disease, CVD)患病风险人群社区公共卫生综合干预血压控制效果。  方法  收集2016—2020年安徽省社区公共卫生综合干预资料(包括基线、3个月、12个月随访数据),采用《中国心血管疾病风险评估和管理指南》推荐的10年CVD风险评估模型将研究对象分为心血管疾病高危和非高危人群,比较高危和非高危人群社区公共卫生综合干预血压控制效果。  结果  共随访3 755名研究对象,CVD高危人群645人,标化检出率10.9%。随访12个月与基线相比,高危人群SBP和DBP分别下降了16.47 mm Hg(95% CI:-18.09~-14.86)、2.66 mm Hg(95% CI:-3.63~-1.69),非高危人群SBP和DBP分别下降了10.43 mm Hg(95% CI:-11.16~-9.70)、2.41 mm Hg(95% CI:-2.81~-2.01);3个月与基线相比,高危人群SBP和DBP分别下降了12.27 mm Hg(95% CI:-13.88~-10.65)、3.66 mm Hg(95% CI:-4.54~-2.77),非高危人群SBP和DBP分别下降了6.05 mm Hg(95% CI:-6.80~-5.30)、2.61 mm Hg(95% CI:-3.00~-2.23)。高危人群随访3个月后SBP下降水平、随访12个月后SBP和DBP下降水平明显高于非高危组(t=-5.100,t=-5.873,t=-2.729,均有P＜0.05)。  结论  社区公共卫生综合干预对CVD高危人群血压改善优于非高危人群。因此,未来的公共卫生工作应进一步关注非高危人群。     

河南省南阳市社区高血压高盐阈居民个体化限盐护理干预效果评价

目的探讨社区高血压高盐阈居民个体化限盐护理干预的效果。方法将南阳市3个社区卫生服务中心中符合纳入标准的高血压居民,随机分为试验组和对照组。对照组给予统一低盐饮食干预,试验组给予个体化低盐饮食干预,分别于干预前、后对2组进行24 h尿钠含量测定(计算饮食中钠摄入量)和血压测量,2组病人追踪随访6个月。结果干预后,从第4个月开始,试验组钠摄入量(7.12±3.17)比对照组(8.34±5.83)及干预前(10.98±8.03)均降低,差异均有统计学意义(P0.05)。干预后6个月,对照组钠摄入量(8.56±4.79)虽然也降低,但与干预前(10.06±8.68)比较,差异无统计学意义(P0.05)。试验组的血压值[收缩压(135.03±12.32)mm Hg,舒张压(86.54±7.32)mm Hg]比对照组[收缩压(140.92±12.82)mm Hg,舒张压(90.78±7.63)mm Hg]及干预前[收缩压(147.23±13.38),舒张压(93.42±8.37)]均降低,差异均有统计学意义(P0.05)。结论对社区高血压高盐阈居民,运用个体化限盐干预的方法,能更好地促使患者达到限制钠盐摄入量、降低血压的效果。     

中国6省18～75岁社区人群低钠盐使用及其与24h尿钠、24h尿钾、钠钾比关系研究

目的 探讨中国6省18～75岁社区人群的低钠盐使用情况,及其与24 h尿钠、24 h尿钾、钠钾比间的关系。方法 采用整群随机抽样方法随机抽取2693名社区人群进行低钠盐使用情况调查,并采集其体格测量数据和24 h尿液。采用线性混合效应模型分析社区人群低钠盐使用情况与其24 h尿钠、24 h尿钾、钠钾比间的关系。结果 中国6省2635名18～75岁社区人群中,听说过低钠盐的社区人群占26.6%,目前使用低钠盐的社区人群占8.8%。社区人群24 h尿钠为(192.97±79.27)mmol/d, 24 h尿钾为(40.16±16.57)mmol/d,钠钾比为(5.18±2.19)。检验结果显示,听说过低钠盐的社区人群的24 h尿钠和钠钾比均低于未听过低钠盐的社区人群,分别为(176.77±70.89)mmol/d和(4.34±2.16),24 h尿钾高于未听说人群,为(40.78±17.07)mmol/d;目前使用低钠盐的社区人群的24 h尿钠和钠钾比均低于未使用低钠盐的社区人群,分别为(166.06±62.92)mmol/d和(4.71±2.11)。线性混合效应模型结果显示,听说过低钠盐...     

24h尿钠法评估汕头市社区居民钠盐摄入情况

目的了解汕头市社区居民钠盐摄入情况及钠钾比,为高血压防控措施的制定提供依据。方法采用整群随机抽样方法抽取汕头市澄海区、龙湖区和金平区164名18~90岁居民,进行现场问卷调查和体格检查,并收集24 h尿液,记录尿量后检测尿液中尿钠、尿钾以及尿肌酐的含量。用SPSS 19.0进行t检验、χ~2检验和Pearson相关分析。结果平均每人每天尿量为(1 692.0±607.1)ml,平均24 h尿钠含量为(130.95±54.99)mmol,尿钾含量为(46.98±24.00)mmol,尿肌酐为(7.47±2.41)mmol,钠钾比为3.32±2.02(男性为3.58±1.96,女性为3.25±2.04),转换为钠盐摄入量为(7.65±3.21)g/d[男性为(7.49±3.12)g/d,女性为(7.70±3.25)g/d]。24 h钠肌酐比值及钾肌酐比值女性均明显高于男性,差异均有统计学意义(P<0.05),而不同性别间24 h尿钠、尿钾含量及钠钾比差异均无统计学意义(P>0.05)。24 h尿钠含量随着体质指数(BMI)的增高而上升(r=0.296,P<0.01)。钠盐摄入量与收缩压和舒张压间均呈明显的正相关(r值分别为0.224、0.275,P<0.01)。结论汕头市社区居民钠盐摄入量高于中国居民膳食指南推荐摄入量,且钠盐摄入水平与血压水平间呈正相关,仍需进一步控制钠盐摄入达标及适当增加钾盐的摄入量。     

24h尿钠、24h尿钾以及钠钾比与肥胖、中心性肥胖的关联分析

目的 了解我国成年人群24 h尿钠、24 h尿钾以及钠钾比与肥胖、中心性肥胖的关联性,为肥胖预防策略的制订提供科学依据。方法 研究数据来源于2018年10—12月开展的中英减盐行动“以社区为基础的中国居民减盐综合干预整群随机对照研究”基线调查数据。采用多阶段随机抽样的方法选取河北、黑龙江、江西、湖南、四川和青海6省18～75岁居民2 639名为研究对象,进行体格检查,采集24 h尿液检测24 h尿钠、24 h尿钾和尿钠钾比水平。采用SAS 9.4软件进行t检验、χ²检验、多重线性回归分析和多因素logistic回归分析。结果 纳入分析2 639名研究对象的平均年龄为(47.4±12.8)岁,肥胖率为17.39%,中心性肥胖率为63.55%。24 h尿钠水平为(192.93±79.19)mmol/d,24 h尿钾水平为(40.15±15.56)mmol/d,尿钠钾比水平为(5.18±2.18)。校正相关混杂因素后,多因素logistic回归模型结果显示,与24 h尿钠最低水平组相比,最高水平组与肥胖、中心性肥胖患病高风险相关(OR=2.427,95%CI:1.739...     

补充钾和钙对血压偏高青年动脉血压及钠代谢影响的长期观察

目的　观察在食盐中添加钾和钙降低血压偏高青年动脉血压的作用及其对钠代谢的影响。方法　选取年龄 18～ 2 2岁的 2 2 0名血压偏高青年 ,采用随机、单盲、对照的方法分为补充钾钙组110名 (男 5 8名 ,女 5 2名 ) ,对照组 110名 (男 5 6名 ,女 5 4名 ) ,进行为期 2年的补钾补钙干预对照试验。干预组及其共同生活的家庭成员每人每天补充钾和钙各 10mmol,与食盐混合在一起。结果　经2年期试验 ,补钾补钙组夜 12h尿中K+含量为 ( 4 8± 2 3 )mmol,尿Na+含量为 ( 6 2 4± 2 8 2 )mmol;对照组尿K+含量为 ( 7 8± 3 6 )mmol,尿Na+含量为 ( 71 8± 2 7 5 )mmol,两者比较 ,差异有显著意义。补钾补钙组血压较基线平均下降了 5 3/ 1 8mmHg ,对照组血压较基线上升了 1 3 / 1 7mmHg,二者比较收缩压相差 6 6mmHg ,舒张压相差 3 5mmHg。结论　在家庭日常食盐中适量添加钾和钙 ,可促进钠盐的排泄 ,降低血压偏高青年的动脉血压 ,是有效预防青年高血压的重要途径。     

Blood pressure response to dietary modifications in free-living individuals

A diet rich in fruits, vegetables, and low-fat dairy foods has been shown to lower blood pressure (BP) when all foods are provided. We compared the effect on BP (measured at home) of 2 different self-selected diets: a low-sodium, high-potassium diet, rich in fruit and vegetables (LNAHK) and a high-calcium diet rich in low-fat dairy foods (HC) with a moderate-sodium, high-potassium, high-calcium DASH-type diet, high in fruits, vegetables and low-fat dairy foods (OD). Subjects were randomly allocated to 2 test diets for 4 wk, the OD and either LNAHK or HC diet, each preceded by a 2 wk control diet (CD). The changes in BP between the preceding CD period and the test diet period (LNAHK or HC) were compared with the change between the CD and the OD periods. Of the 56 men and 38 women that completed the OD period, 43 completed the LNAHK diet period and 48 the HC diet period. The mean age was 55.6 +/- 9.9 (+/-SD) years. There was a fall in systolic pressure between and the CD and OD [-1.8 +/- 0.5 mm Hg (P < 0.001)]. Compared with OD, systolic and diastolic BPs fell during the LNAHK diet period [-3.5 +/- 1.0 (P < 0.001) and -1.9 +/- 0.7 (P < 0.05) mmHg, respectively] and increased during the HC diet period [+3.1 +/- 0.9 (P < 0.01) and +0.8 +/- 0.6 (P = 0.15) mm Hg, respectively]. A self-selected low-sodium, high-potassium diet resulted in a greater fall in BP than a multifaceted OD, confirming the beneficial effect of dietary intervention on BP in a community setting.     

Sodium, potassium, body mass, alcohol and blood pressure in three United Kingdom centres (the INTERSALT study)

Standardised data on blood pressure, 24 h urinary electrolyte excretion, body mass index (BMI) and alcohol intake were collected as part of the INTERSALT study in 598 men and women aged 20-59 years, selected randomly from three population groups in the United Kingdom. For the three centres combined, mean systolic blood pressure was 121.4 mm Hg and diastolic pressure 72.1 mm Hg, urinary sodium excretion 152.1 mmol/24 h, urinary potassium excretion 61.0 mmol/24 h, urinary sodium/potassium ratio 2.64 and BMI 25.2 kg/m2. Prevalence of heavy alcohol drinking in men (greater than or equal to 300 ml/week) was 27.5 per cent. Applying overall INTERSALT regression coefficients to the United Kingdom data suggested that modest changes in average sodium and potassium intakes, together with reductions in the prevalence of obesity and (in men) of heavy alcohol drinking could lead to important reductions in average population blood pressures and the prevalence of hypertension. The potential of this multifactorial approach to blood pressure control was illustrated by stratifying individuals within each of the United Kingdom centres by sodium and potassium excretion, BMI and alcohol intake. The 20 (out of 299) men considered at 'lower risk' for high blood pressure with respect to the above variables had systolic pressure lower by 11 mm Hg (P less than 0.01); for the 27 (out of 299) 'lower risk' women, systolic pressure was lower by 5 mm Hg (P = 0.06). These non-pharmacological approaches towards more favourable blood pressure levels could be accompanied by reductions in mortality from stroke and coronary heart disease.     

Does dietary recall adequately assess sodium, potassium, and calcium intake in hypertensive patients?

OBJECTIVE: A diet low in sodium, high in potassium, and high in calcium is recommended to lower blood pressure. However, compliance with this diet is poor, probably because of dietary intake underestimation. Therefore, we compared electrolyte intake as estimated from dietary recall with a 24-h urinary excretion. METHODS: Thirty-six patients (26 men and 10 women) with a mean age of 46 +/- 8 y participated in the study. All participants had essential hypertension and were on no drug therapy (n = 20) or non-diuretic monotherapy (n = 16). Patients were instructed to consume a low-sodium (50 mmol/d), high-potassium (supplementation with 30 to 60 mmol/d), and high-calcium (1000 mg/d) diet. Compliance with the diet was assessed at baseline and then 1, 2, and 3 mo after starting the diet. Sodium, potassium, and calcium intakes were carefully estimated from patients' dietary recall and 24-h urinary collection. RESULTS: Estimated sodium intake significantly correlated with 24-h urinary excretion (R = 0.43 P < 0.001). However, estimated sodium intake was lower than urinary sodium excretion by 34% at baseline and by 47% after 3 mo of dieting (P < 0.05). Estimated potassium intake correlated with 24-h urinary excretion. Estimated calcium intake significantly increased from 933 +/- 83 mg/d to 1029 +/- 171 mg/d (P < 0.05). Calcium intake derived from patients' recall far exceeded and only slightly correlated with 24-h urinary excretion (R = 0.23, P < 0.01). CONCLUSIONS: Patients tend to underestimate their sodium intake by 30% to 50%; therefore, urinary sodium excretion is more accurate to assess sodium intake. Thus, 24-h urinary sodium excretion should be used in clinical practice and in clinical trials, especially when dietary non-compliance is suspected.     

Decreasing dietary sodium while following a self-selected potassium-rich diet reduces blood pressure

Reducing dietary sodium reduces blood pressure (BP), a major risk factor for cardiovascular disease, but few studies have specifically examined the effect on BP of altering dietary sodium in the context of a high potassium diet. This randomized, crossover study compared BP values in volunteer subjects self-selecting food intake and consuming low levels of sodium (Na+; 50 mmol/d) with those consuming high levels of sodium (> or =120 mmol/d), in the context of a diet rich in potassium (K+). Sodium supplementation (NaSp) produced the difference in Na+ intake. Subjects (n = 108; 64 women, 44 men; 16 on antihypertensive therapy) had a mean age of 47.0 +/- 10.1 y. Subjects were given dietary advice to achieve a low sodium (LS) diet with high potassium intake (50 mmol Na+/d, >80 mmol K+/d) and were allocated to NaSp (120 mmol Na+/d) or placebo treatment for 4 wk before crossover. The LS diet decreased urinary Na+ from baseline, 138.7 +/- 5.3 mmol/d to 57.8 +/- 3.8 mmol/d (P < 0.001). The NaSp treatment returned urinary Na+ to baseline levels 142.4 +/- 3.7 mmol/d. Urinary K+ increased from baseline, 78.6 +/- 2.3 to 86.6 +/- 2.1 mmol/d with the LS diet and to 87.1 +/- 2.1 mmol/d with NaSp treatment (P < 0.001). The LS diet reduced home systolic blood pressure (SBP) by 2.5 +/- 0.8 mm Hg (P = 0.004), compared with the NaSp treatment. Hence, reducing Na+ intake from 140 to 60 mmol/d significantly decreased home SBP in subjects dwelling in a community setting who consumed a self-selected K+-rich diet, and this dietary modification could assist in lowering blood pressure in the general population.     

北京市家庭低钠盐使用情况及影响因素研究

目的了解北京市家庭低钠盐使用情况及其影响因素,探究低钠盐使用对钠盐摄人量、尿液中钠／钾比值及血压等的影响。方法采用自行设计的知识和行为调查问卷,于2011年对两阶段整群抽样的方法抽取的北京市城区、郊区各4所学校随机抽中班级的学生家长进行横断面调查并进行体格测量,收集家庭低钠盐使用、影响因素及相关知识行为情况及其血压情况;并对其中少部分家庭成员进行7d的24h尿液收集,分析低钠盐使用对钠盐摄入量、尿液中钠／钾离子比值和血压的影响。结果共1034位家长参与了问卷调查,合格问卷903份,其中27．4％的家庭正在使用低钠盐,城乡分别为27．0％和27．6％（P〉0．05）;家庭主要烹饪者的性别和低钠盐相关知识的知晓是影响低钠盐使用的主要因素,女性及知晓低钠盐知识的人更倾向于使用低钠盐。11户家庭的26位调查对象成功完成了尿液收集,低钠盐组和普通盐组尿钠／钾离子比分别为（2．6±0．8）、（3．4±0．8）（P〈0．01）,总人日均钠盐摄人量分别为（16．5±3．5）g、（19．2±4．6）g（P〉0．05）,两组收缩压和舒张压均差异无统计学意义（P〉0．05）。结论北京市低钠盐推广行动初见成效,加强低钠盐相关知识普及及健康教育对低钠盐的推广具有积极意义。     

Randomized Trial on the Effects of Dietary Potassium on Blood Pressure and Serum Potassium Levels in Adults with Chronic Kidney Disease

In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; p = 0.16) and DBP (−0.70 mm Hg; p = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (p = 0.054) and −0.08 mm Hg for DBP (p = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (p = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD.     

Low-sodium, high-potassium diet: feasibility and acceptability in a normotensive population

Sixty-nine normotensive volunteers participated in an eight-week study to test the feasibility and acceptability of two low-sodium (less than 70 mEq), high-potassium (greater than 100 mEq) diets. The diet groups differed only in the use of KCl salt substitute. Both dietary groups were able to reduce sodium and increase potassium intake compared to the control group. Urine sodium excretion decreased in the diet groups but no change was observed in potassium. Potassium chloride salt substitute was not used as recommended, suggesting its unacceptability.     

Core Strategies to Increase the Uptake and Use of Potassium-Enriched Low-Sodium Salt

Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced with minerals such as potassium chloride. Low-sodium salt may be an effective, scalable, and sustainable approach to reduce sodium and therefore reduce blood pressure and cardiovascular disease at the population level. Low-sodium salt programs have not been widely scaled up, although they have the potential to both reduce dietary sodium intake and increase dietary potassium intake. This article proposes a framework for a successful scale-up of low-sodium salt use in the home through four core strategies: availability, awareness and promotion, affordability, and advocacy. This framework identifies challenges and potential solutions within the core strategies to begin to understand the pathway to successful program implementation and evaluation of low-sodium salt use.