Can Salt Substitution Save At-Risk Persons from Stroke?

This editorial discusses the Salt Substitute and Stroke Study (SSaSS), a large-scale trial involving 20,995 high-risk individuals in rural China. The study compared regular salt (100% sodium chloride) with a salt substitute (75% sodium chloride and 25% potassium chloride). Results showed that the salt substitute reduced stroke rates (29.14 vs. 33.65 events per 1000 person-years; rate ratio, 0.86; P=0.006), major cardiovascular events, and all-cause mortality without increasing hyperkalemia risk. The findings highlight the potential public health benefits of salt substitution in populations with high dietary sodium intake, though generalizability to other settings (e.g., processed-food-heavy diets) remains uncertain.

This editorial discusses the Salt Substitute and Stroke Study (SSaSS), a large-scale trial involving 20,995 high-risk individuals in rural China. The study compared regular salt (100% sodium chloride) with a salt substitute (75% sodium chloride and 25% potassium chloride). Results showed that the salt substitute reduced stroke rates (29.14 vs. 33.65 events per 1000 person-years; rate ratio, 0.86; P=0.006), major cardiovascular events, and all-cause mortality without increasing hyperkalemia risk. The findings highlight the potential public health benefits of salt substitution in populations with high dietary sodium intake, though generalizability to other settings (e.g., processed-food-heavy diets) remains uncertain.