{"id":"efb4fc55d5c2","type":"article","url":"https://hartvaat.nl/2022/09/26/zoutvervangers-verminderen-cardiovasculaire-events-systematische-review/","title":"Zoutvervangers verminderen cardiovasculaire events: systematische review","title_en":"Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","atleten","biomarkers-cardiovasculair","bradycardie","cardiogene-shock","farmaco-economie","fractional-flow-reserve","hartrevalidatie","hypertrofische-cardiomyopathie","inflammatie","lichaamsbeweging","obesitas","ouderen","plotse-hartdood","richtlijnen-esc","roken","secundaire-preventie","select-trial","slaapapneu"],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2022-321332","source_url":"https://doi.org/10.1136/heartjnl-2022-321332","authors":["Xuejun Yin","Anthony Rodgers","Adam Perkovic","Liping Huang","Ka-Chun Li","Jie Yu","Yangfeng Wu","J H Y Wu","Matti Marklund","Mark D Huffman","J Jaime Miranda","Gian Luca Di Tanna","Darwin Labarthe","Paul Elliott","Maoyi Tian","Bruce Neal"],"significance":8,"published":"2022-09-26","source_date":"2022-09-26","image":"","kennis":[],"congress":"","summary_en":"This systematic review and meta-analysis confirmed that potassium-enriched salt substitutes lower blood pressure and reduce cardiovascular events and all-cause mortality, reinforcing the SSaSS results and supporting salt substitution as a scalable public health intervention.","created":"2026-07-03T10:29:57Z","updated":"2026-07-03T18:38:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review en meta-analyse bevestigden dat kaliumverrijkte zoutvervangers de bloeddruk verlagen en cardiovasculaire events en sterfte verminderen, zonder significant risico op hyperkaliëmie. Dit is een eenvoudige, goedkope preventieve interventie op populatieniveau.","abstract_original":"OBJECTIVES: The Salt Substitute and Stroke Study (SSaSS) recently reported blood pressure-mediated benefits of a potassium-enriched salt substitute on cardiovascular outcomes and death. This study assessed the effects of salt substitutes on a breadth of outcomes to quantify the consistency of the findings and understand the likely generalisability of the SSaSS results. METHODS: We searched PubMed, Embase and the Cochrane Library up to 31 August 2021. Parallel group, step-wedge or cluster randomised controlled trials reporting the effect of salt substitute on blood pressure or clinical outcomes were included. Meta-analyses and metaregressions were used to define the consistency of findings across trials, geographies and patient groups. RESULTS: There were 21 trials and 31 949 participants included, with 19 reporting effects on blood pressure and 5 reporting effects on clinical outcomes. Overall reduction of systolic blood pressure (SBP) was -4.61 mm Hg (95% CI -6.07 to -3.14) and of diastolic blood pressure (DBP) was -1.61 mm Hg (95% CI -2.42 to -0.79). Reductions in blood pressure appeared to be consistent across geographical regions and population subgroups defined by age, sex, history of hypertension, body mass index, baseline blood pressure, baseline 24-hour urinary sodium and baseline 24-hour urinary potassium (all p homogeneity >0.05). Metaregression showed that each 10% lower proportion of sodium choloride in the salt substitute was associated with a -1.53 mm Hg (95% CI -3.02 to -0.03, p=0.045) greater reduction in SBP and a -0.95 mm Hg (95% CI -1.78 to -0.12, p=0.025) greater reduction in DBP. There were clear protective effects of salt substitute on total mortality (risk ratio (RR) 0.89, 95% CI 0.85 to 0.94), cardiovascular mortality (RR 0.87, 95% CI 0. 81 to 0.94) and cardiovascular events (RR 0.89, 95% CI 0.85 to 0.94). CONCLUSIONS: The beneficial effects of salt substitutes on blood pressure across geographies and populations were consistent. Blood pressure-mediated protective effects on clinical outcomes are likely to be generalisable across population subgroups and to countries worldwide. TRIAL REGISTRATION NUMBER: CRD42020161077."}