Background: The beneficial effects of potassium-enriched salt on
blood pressure have been reported in a few short-term trials. The
long-term effects of potassium-enriched salt on cardiovascular mortality
have not been carefully studied.
Objective: The objective was to examine the effects of potassiumenriched
salt on cardiovascular disease (CVD) mortality and medical
expenditures in elderly veterans.
Design: Five kitchens of a veteran retirement home were randomized
into 2 groups (experimental or control) and veterans assigned to
those kitchens were given either potassium-enriched salt (experimental
group) or regular salt (control group) for 31 mo. Information
on death, health insurance claims, and dates that veterans moved
in or out of the home was gathered.
Results: Altogether, 1981 veterans, 768 in the experimental
[x (SD) age: 74.8 7.1 y] and 1213 in the control (age: 74.9
6.7 y) groups, were included in the analysis. The experimental group
had better CVD survivorship than did the control group. The incidence
of CVD-related deaths was 13.1 per 1000 persons (27 deaths
in 2057 person-years) and 20.5 per 1000 (66 deaths in 3218 personyears)
for the experimental and control groups, respectively. A significant
reduction inCVDmortality (age-adjusted hazard ratio: 0.59;
95%CI: 0.37, 0.95) was observed in the experimental group. Persons
in the experimental group lived 0.3– 0.90 y longer and spent significantly
less (US $426/y) in inpatient care for CVD than did the
control group, after control for age and previous hospitalization
expenditures.
Conclusions: 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 effect was likely due to a major increase in potassium
and a moderate reduction in sodium intakes.