TY - JOUR AU - Yan L. AU - He F. AU - Lam C. AU - Xie W. AU - Wu Y. AU - Zhao X. AU - Li S. AU - Ke L. AU - Li X. AU - Yin X. AU - Sang B. AU - Luobu G. AB -

OBJECTIVES: To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters). METHOD: The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP>/=140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months' supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted. RESULTS: After the three months' intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was -8.2/-3.4 mmHg (all p<0.05) in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at -7.6/-3.5 mmHg with multiple imputations (all p<0.05). Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg) was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027). CONCLUSION: Low sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. TRIAL REGISTRATION: ClinicalTrials.gov NCT01429246.

AD - Department of Cardiology, Beijing Jishuitan Hospital, 4th medical college of Peking University, Beijing, China.
The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
The George Institute for Global Health at Peking University Health Science Center, Beijing, China,; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America.
Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
Dangxiong People's Hospital, Tibet, China.
Tibet Autonomous Region People's Hospital, Tibet, China.
The George Institute for Global Health at Peking University Health Science Center, Beijing, China,; Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China. AN - 25338053 BT - PLoS One DP - NLM ET - 2014/10/23 LA - eng LB - CHINA M1 - 10 N1 - Zhao, Xingshan
Yin, Xuejun
Li, Xian
Yan, Lijing L
Lam, Christopher T
Li, Shenshen
He, Feng
Xie, Wuxiang
Sang, Ba
Luobu, Gesang
Ke, Liang
Wu, Yangfeng
United States
PLoS One. 2014 Oct 22;9(10):e110131. doi: 10.1371/journal.pone.0110131. eCollection 2014. N2 -

OBJECTIVES: To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters). METHOD: The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP>/=140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months' supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted. RESULTS: After the three months' intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was -8.2/-3.4 mmHg (all p<0.05) in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at -7.6/-3.5 mmHg with multiple imputations (all p<0.05). Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg) was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027). CONCLUSION: Low sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. TRIAL REGISTRATION: ClinicalTrials.gov NCT01429246.

PY - 2014 SN - 1932-6203 (Electronic)
1932-6203 (Linking) EP - e110131 T2 - PLoS One TI - Using a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomised controlled trial VL - 9 ER -