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Substituting Salt With a Potassium Salt May Benefit Elderly Veterans

  • Authors: News Author: Laurie Barclay, MD
    CME Author: Charles Vega, MD, FAAFP
  • CME Released: 6/14/2006
  • Valid for credit through: 6/14/2007
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Target Audience and Goal Statement

This article is intended for primary care clinicians, cardiologists, and other specialists who care for adults at risk for CVD.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • Describe the blood pressure–lowering effects of reducing dietary sodium intake and following the Dietary Approaches to Stop Hypertension (DASH) diet.
  • Identify outcomes improved by replacing sodium chloride with potassium chloride in the diet.


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  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.


    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.


  • Gary Vogin, MD

    Senior Medical Editor, Medscape


    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

CME Author(s)

  • Charles P Vega, MD

    Associate Professor; Residency Director, Department of Family Medicine, University of California, Irvine


    Disclosure: Charles Vega, MD, FAAFP, has disclosed that he has received grants for educational activities from Pfizer.

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Substituting Salt With a Potassium Salt May Benefit Elderly Veterans

Authors: News Author: Laurie Barclay, MD CME Author: Charles Vega, MD, FAAFPFaculty and Disclosures

CME Released: 6/14/2006

Valid for credit through: 6/14/2007


June 14, 2006 — Substituting table salt with a potassium salt is beneficial for elderly veterans in Taiwan, according to the results of a randomized trial reported in the June issue of the American Journal of Clinical Nutrition.

"The beneficial effects of potassium-enriched salt on blood pressure have been reported in a few short-term trials," write Hsing-Yi Chang, MD, from the Institute of Biomedical Sciences, Academia Sinica in Nan-Kang, Taipei, Taiwan, ROC, and colleagues. "The long-term effects of potassium-enriched salt on cardiovascular mortality have not been carefully studied."

At a veteran retirement home, 5 kitchens were randomized into 2 groups (experimental or control), and veterans assigned to those kitchens were randomized to receive either potassium-enriched salt (experimental group) or regular salt (control group) for about 31 months.

Of 1981 veterans studied, 768 were in the experimental group (mean age, 74.8 ± 7.1 years), and 1213 were in the control group (mean age, 74.9 ± 6.7 years). Compared with the control group, the experimental group had better survival from cardiovascular death (CVD). CVD-related death occurred in 13.1 per 1000 persons in the experimental group (27 deaths in 2057 person-years) and in 20.5 per 1000 persons in the control group (66 deaths in 3218 person-years).

CVD mortality was significantly lower in the experimental group (age-adjusted hazard ratio, 0.59; 95% confidence interval, 0.37 - 0.95). After controlling for age and previous hospitalization expenditures, persons in the experimental group lived 0.3 to 0.90 years longer and spent significantly less (about US $426/year) in inpatient care for CVD than did the control group.

"This study showed a long-term beneficial effect on CVD mortality and medical expenditure associated with a switch from regular salt to potassium-enriched salt in a group of elderly veterans," the authors write. "The effect was likely due to a major increase in potassium and a moderate reduction in sodium intakes.... Additional studies are encouraged to demonstrate the beneficial effects of a reduction in dietary sodium and an increase in potassium intake in the general population and to clarify whether the effect comes from lower sodium intake or from higher potassium intake."

Taiwan Salt Work funded this study. The authors have disclosed no relevant financial relationships.

Am J Clin Nutr. 2006;83:1289-1296