In the news: Salt ‘Subs’ to Help Maintain Healthy Blood Pressure with Age

Salt ‘Sub’ May Cut Risk of Hypertension with Age

Because eating too much salt can increase blood pressure in many people with hypertension, restricting salt is recommended to help control elevated pressure. But cutting down on salt in the diet can be difficult.

That’s why the results of the DECIDE-Salt study(1) published in 2023 were well received. The study compared two salt reduction strategies – replacing regular table salt with a blend of sodium chloride and potassium chloride versus a dietary strategy of progressively reducing salt intake over time.

After two years, the researchers found that using a salt substitute (62.5 % sodium chloride and 25% potassium chloride) lowered both systolic and diastolic blood pressure better in older participants (people 55 and older) compared to consuming their usual salt intake. Salt substituion was also better than the gradual salt restriction approach.

It’s known that the risk of developing high blood pressure goes up as we grow older. One reason for the increased risk is because blood vessels become more rigid and less elastic with age. In turn, that increases blood pressure and requires the heart to pump harder.

Not Just for People with Hypertension

A new analysis of the DECIDE-Salt study(2) also affirms that salt substitutes can be beneficial not only for those with high blood pressure, but also for healthy older people without hypertension to maintain healthy blood pressure.

Participants with normal blood pressure who switched to the potassium-enhanced salt substitute were 40% less likely to develop hypertension compared to those who continuted their regular salt intake.

At the end of two years, the usual salt intake group experienced a significant increase in blood pressure, while there was no systolic/diastolic change in the salt substitute group.

The researchers saw no difference between groups in episodes of low blood pressure (hypotension), indicating that the potassium enrichment didn’t cause blood pressure to dip too low.

Are Salt Substitutes Safe?

Using reasonable amounts of potassium enriched-salt substitutes is generally safe for most people. However those with kidney disease, diabetes and heart failure should check with their physician before using a salt substitute as medical supervision is required.

The same holds true for people taking certain medications that can reduce potassium excretion such as potassium-sparing diuretics and ACE inhibitors – medications that may up the risk of high blood levels of potassium.

Reducing Salt with Herbs?

Certain spices may also help in the effort to reduce salt intake according to a newly published study(3). The authors tested several spices to see which if any could add to the perceivied salty taste of food.

Turmeric, bay leaf and parseley appeared to increase saltiness of food – an effect which was attributed to the aroma of a compound that all three herbs contained: eugenol.

About 1/6 tsp. (300 mg) of turmeric and a bit more than 1/8 tsp. (900 mg) of salt made a serving of food taste nearly as salty as adding about ½ tsp. (2400 mg) of salt. Adding a bay leaf increased perceived saltiness 16% more than the turmeric. Parseley increased saltiness too, though less than turmeric.

References

1. Yifang Yuan, et al. Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial. Nature Med. 29:973–981, 2023.
2. Xianghui Zhang, et al. Effect of a salt substitute on incidence of hypertension and hypotension among normotensive adults. J Am Coll Cardiol. 83 (7) 711–722, 2024.
3. Segura-Borrego M, et al. Could the aroma of spices produce a cross modal enhancement of food saltiness and contribute to reducing salt intake? Sci Food Agri. Epub Feb. 3, 2024.