IMPACT OF LONG-TERM CONSUMPTION OF POTASSIUM -ENRICHED SALT ON BLOOD PRESSURE AND MORTALITY IN THE NURSING HOME POPULATION

Objective: To examine the effects of long-term consumption of potassium-enriched salt (KCl: NaCl=1:1 by weight) on various health outcomes, including blood pressure, urinary sodium-potassium ratio, stroke, cardiovascular disease (CVD), and all-cause mortality, among individuals living in nursing homes. Design and method: In northern China, a total of 29 nursing homes were selected using cluster random sampling, with each county representing a cluster. These nursing homes were then divided into two groups: the intervention group, which consumed potassium-enriched, low-sodium salt, and the control group, which consumed regular salt. Baseline and seven follow-up surveys were conducted using standard cardiovascular disease epidemiological survey methods from 2011 to 2018. For the purpose of survival analysis, the population considered consisted of individuals aged 40 years or older who had stayed in the nursing home for at least six months. Results: In the baseline assessment, there were no significant differences in the average blood pressure between the two groups. However, during the follow-up surveys, it was observed that the intervention group had significantly lower systolic blood pressure (SBP) and a lower sodium-potassium ratio. The survival analysis was conducted on a total of 3543 participants, with 1065 death events recorded. After adjusting for age and sex using Cox proportional hazards models, the intervention group had an HR of 0.883 (95% CI 0.782-0.997) compared to the control group for all-cause mortality. Subgroup analysis was also performed for individuals aged 40-70 years, which revealed that the intervention group had lower HRs for all-cause mortality, CVD (including stroke), and stroke death, with HRs of 0.780 (95% CI 0.633-0.964), 0.664 (95% CI 0.489-0.903), and 0.681 (95% CI 0.473-0.981), respectively. For individuals aged over 70 years, the results were not statistically significant. Conclusions: Long-term consumption of potassium-enriched salt in northern China is safe and feasible. It significantly reduces blood pressure, and urinary sodium-potassium ratio, and lowers the risk of mortality in individuals aged 40-70. These results support the potential benefits of using potassium-enriched, low-sodium salt as a public health intervention to improve cardiovascular health outcomes in this population.