# Zoutvervangers verminderen cardiovasculaire events: systematische review

*geplaatst 2022-09-26 · Atriumfibrilleren · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2022-321332 · https://hartvaat.nl/2022/09/26/zoutvervangers-verminderen-cardiovasculaire-events-systematische-review/*

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.

## English: Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2022-321332. Bijgewerkt 2026-07-03T18:38:55Z. 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.