Swapping salt for potassium-enriched salt substitutes may be the best choice for people who have already experienced a stroke. Image credit: Holcy/Getty Images.
- Reducing sodium and increasing
potassium intake can be a crucial strategy for minimizing the risk of
stroke.
- Recent research indicates that using
potassium-enriched salt substitutes instead of regular salt may lead to a
14% reduction in recurrent stroke rates and a 21% decrease in deaths
related to strokes.
- Experts suggest that salt substitutes may help reduce stroke risk as a simple, low-cost intervention but should be part of a healthy diet and lifestyle.
Stroke remains a major health challenge in the United States,
ranking as one of the leading causes of deathTrusted Source and long-term
disabilityTrusted Source.
According to the Centers of Disease
Control and Prevention (CDC), over 795,000 peopleTrusted Source experience a stroke annually,
with someone dying from a stroke nearly every 3 minutesTrusted Source. Alarmingly, nearly one in four
strokes are recurrentTrusted
Source,
affecting individuals who have already suffered a previous stroke.
Preventing strokes and mitigating
their impact on individuals and families is crucial.
A new study offers hope, highlighting
the potential of salt substitutes as a promising strategy to reduce stroke
recurrence and mortality.
The research, published in JAMA CardiologyTrusted Source, suggests that replacing regular
salt with a potassium-enriched salt substitute may be a low-cost, safe, and
effective stroke intervention.
Results showed a significant 14%
reduction in recurrent stroke rates and a 21% decrease in stroke-related deaths
for those using a salt substitute compared to regular table salt.
These findings follow new guidelines from the World Health
Organization (WHO) regarding lower sodium salt substitutes and build on
previous studies supporting the role of salt substitutes in promoting vascular
health.
Potassium-enriched salt substitutes lower recurrent stroke and death risk
This study was a subgroup analysis of
participants from the Salt Substitute and Stroke Study
(SSaSS), a large
randomized clinical trial conducted across 600 villages in northern China. It
followed participants for an average of around 5 years.
The SSaSS investigated how a
potassium-enriched salt substitute could affect the risk of stroke, major
cardiovascular events, and mortality compared to regular salt.
The substitute was composed of 75%
sodium chloride and 25% potassium chloride.
This particular subgroup analysis
included 15,249 individuals with a prior history of stroke. The average age of
participants was 64 years, with 54.1% being male. Researchers evaluated their
data between November 2023 and August 2024.
Among these participants, there were
2,735 cases of recurrent strokes, which included 691 fatal strokes and 2,044
nonfatal ones, as well as 3,242 recorded deaths.
The researchers found that those using
the salt substitute instead of regular salt had a 14% reduction in the risk of
recurrent strokes and a 12% decrease in overall mortality rates.
The results were even more pronounced
for hemorrhagic strokes, showing a 30% reduction, and for
stroke-related deaths, which decreased by 21%.
Importantly, the use of the
potassium-enriched salt substitute did not significantly increase the risk
of high potassium levels (hyperkalemia).
How salt substitutes work to lower stroke risk
Diet, including salt intake, plays an
important role in the risk of stroke. Regular table salt contains high levels
of sodium, which can raise blood pressure when consumed in excess.
“Over time [high blood pressure]
causes increased stress on the blood vessel walls, causing them to develop
plaques and narrowing,” Rebecca
DiBiase, MD, MPH,
assistant professor of vascular neurology at the Yale New Haven Stroke Center,
not involved in the study, told Medical News Today.
She explained that “narrowed blood
vessels in the heart can make people more likely to have heart attacks, and
narrowed blood vessels leading to and inside the brain can make people more
likely to experience stroke.”
Thomas M. Holland, MD, MS, a physician-scientist and assistant
professor at the RUSH Institute for Healthy Aging, RUSH University, College of
Health Sciences, who was also not involved in the study, noted that
“reduced-sodium replaced by added-potassium salt as substitutes help lower
blood pressure by reducing sodium intake, which directly reduces vascular
strain.”
He also pointed out that “the
potassium component has a vasodilatory [vessel widening] effect, further
enhancing and helping with blood pressure control.”
Holland explained that the
combination of decreased sodium and increased potassium “reduces the risk of
stroke recurrence and stroke-related deaths by mitigating a major stroke risk
factor — the blood pressure.”
Previous research suggests that “even a small
reduction in blood pressure (as little as 1 mm Hg) can lower stroke risk by
5%,” noted Kiran
Campbell, RDN,
a registered dietitian specializing in cardiovascular health.
Therefore, she added, “swapping
regular salt for a potassium-enriched salt substitute offers a low-effort,
high-impact solution for stroke survivors.”
Improving your sodium-potassium ratio for better vascular health
Campbell, who also had no involvement
in the recent study, highlighted that the body’s sodium-to-potassium
ratioTrusted Source may impact blood pressure more
significantly than sodium or potassium alone, particularly in people with high
blood pressure.
Therefore, while potassium-enriched
salt substitutes may be a helpful option, Campbell recommends also focusing on
increasing potassium-rich foods and minimizing high-sodium sources to promote
heart health and reduce stroke risk.
She recommends incorporating the
following high-potassium foods:
- potatoes (with the skin on)
- tomatoes
- bananas
- avocados
- canned or dried beans and lentils
- yogurt
- leafy greens
- unsweetened dried fruits.
“In addition to improving the
sodium-to-potassium ratio, these foods provide essential fiber and phytonutrients that further promote
cardiovascular health,” she explained.
She cautioned that those taking
certain medications and “people with kidney disease or reduced kidney function should be careful with potassium
intake and should not use potassium-enriched salt
substitutes.”
Campbell also recommended practical
ways to lower sodium intake, such as:
- seasoning meals with herbs and
spices instead of salt
- choosing fresh, whole foods over
highly processed and convenience items
- opting for “no salt added” or
low-sodium options when grocery shopping
- preparing meals at home instead
of eating at restaurants to better control sodium content.
Broader dietary and lifestyle changes to reduce stroke risk
While salt substitutes show promise,
experts agree they should be part of a healthy diet and lifestyle for maximum
benefit.
“As you can imagine, beyond salt
substitution, adopting a broader approach to dietary change—such as increasing
fresh fruit and vegetable intake and reducing intake of processed foods, fried fast foods, baked goods—can further enhance
neurovascular and cardiovascular health.”— Thomas Holland, MD, MS
DiBiase suggested an evidence-based
approach, the DASH diet (Dietary Approaches to Stop Hypertension). It focuses
on nutrient-dense foods like fruits, vegetables, and whole grains while
minimizing sodium.
“This diet is not very restrictive
and can be adopted with some relatively simple modifications,” she noted.
“[Simply] adopting a healthier diet
and exercise habits can go a long way in decreasing
people’s risk of stroke and heart disease,” said DiBiase.
She concluded by exclaiming, “the
earlier we can teach this and have people implement these changes every day,
the healthier our world will be!”
No comments:
Post a Comment