{"id":"12faea3a61b4","type":"article","url":"https://hartvaat.nl/2024/02/20/zoutvervanger-voorkomt-hypertensie-bij-normotensieve-volwassenen/","title":"Zoutvervanger voorkomt hypertensie bij normotensieve volwassenen","title_en":"Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","bisoprolol","bloeddrukbehandeling","ezetimibe","figaro-dkd","perifeer-vaatlijden","precision-trial","primaire-preventie","renale-denervatie","select-trial","summit-trial","vrouwen","zwangerschap-hart"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2023.12.013","source_url":"https://doi.org/10.1016/j.jacc.2023.12.013","authors":["Xianghui Zhang","Yifang Yuan","Chenglong Li","Xiangxian Feng","Hongxia Wang","Qianku Qiao","Ruijuan Zhang","Aoming Jin","Jiayu Li","Huijuan Li","Yangfeng Wu"],"significance":7,"published":"2024-02-20","source_date":"2024-02-20","image":"","kennis":["https://hartvaat.nl/kennis/preventie/aspirine-primaire-preventie/"],"congress":"","summary_en":"This randomized trial showed that a potassium-enriched salt substitute significantly reduces the incidence of hypertension in normotensive adults, demonstrating that population-level dietary sodium-potassium modification can prevent blood pressure elevation before it starts.","created":"2026-07-03T10:30:47Z","updated":"2026-07-03T18:39:08Z","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":"Gerandomiseerde trial toonde dat een kaliumverrijkte zoutvervanger de incidentie van hypertensie significant verminderde bij normotensieve volwassenen. Deze primaire preventieve benadering kan op populatieniveau de hypertensie-epidemie dempen.","abstract_original":"BACKGROUND: Reports on the effects of salt substitution among individuals with normal blood pressure are scarce and controversial. OBJECTIVES: This study sought to assess the effects of a salt substitute (62.5% NaCl, 25% KCl, and 12.5% flavorings) on incidence of hypertension and hypotension among older adults with normal blood pressure. METHOD: A post hoc analysis was conducted among older adults with normal blood pressure participating in DECIDE-Salt, a large, multicenter, cluster-randomized trial in 48 elderly care facilities for 2 years. We used the frailty survival model to compare risk of incident hypertension and the generalized linear mixed model to compare risk of hypotension episodes. RESULTS: Compared with usual salt group (n = 298), the salt substitute group (n = 313) had a lower hypertension incidence (11.7 vs 24.3 per 100 person-years; adjusted HR: 0.60; 95% CI: 0.39 to 0.92; P = 0.02) but did not increase incidence of hypotension episodes (9.0 vs 9.7 per 100 person-years; P = 0.76). Mean systolic/diastolic blood pressure did not increase from the baseline to the end of intervention in the salt substitute group (mean changes: -0.3 ± 11.9/0.2 ± 7.1 mm Hg) but increased in the usual salt group (7.0 ± 14.3/2.1 ± 7.5 mm Hg), resulting in a net reduction of -8.0 mm Hg (95% CI: -12.4 to -3.7 mm Hg) in systolic and -2.0 mm Hg (95% CI: -4.1 to 0.1 mm Hg) in diastolic blood pressure between intervention groups. CONCLUSIONS: In Chinese older adults with normal blood pressure, replacing usual salt with a salt substitute may reduce the incidence of hypertension without increasing hypotension episodes. This suggests a desirable strategy for population-wide prevention and control of hypertension and cardiovascular disease, deserving further consideration in future studies. (Diet Exercise and Cardiovascular Health [DECIDE]-Salt Reduction Strategies for the Elderly in Nursing Homes in China [DECIDE-Salt]; NCT03290716)."}