Trial reportNature medicine2020
Effect of salt substitution on community-wide blood pressure and hypertension incidence.
Trial report in Nature medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 101 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Launching a Salt Substitute to Reduce Blood Pressure at the Population Level - Peru
The use of potassium-rich salt substitutes in blood pressure control of kidney transplant recipients
Who cites it
101 citing papers in PubMed, 9 syntheses or guidelines pooled it, 201 citations in OpenAlex.
- Comparative effects of salt substitutes on blood pressure, cardiovascular events and mortality: a systematic review and network meta-analysis.BMC medicine · 2026Pooled it
- Effect of population-based sodium reduction interventions on blood pressure: a systematic review and meta-analysis of randomized trials.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- Systematic Review of Social Marketing as a Behavior Change Agent in Salt Reduction.Global heart · 2025Pooled it
- Effectiveness of salt substitute on cardiovascular outcomes: A systematic review and meta-analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2022Pooled it
- Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women.The Cochrane database of systematic reviews · 2022Pooled it
- Urban-rural differences in hypertension prevalence in low-income and middle-income countries, 1990-2020: A systematic review and meta-analysis.PLoS medicine · 2022Pooled it
- Pooled it
- The impact of baseline potassium intake on the dose-response relation between sodium reduction and blood pressure change: systematic review and meta-analysis of randomized trials.Journal of human hypertension · 2021Pooled it
- Community-Based Interventions for Hypertension Control in Latin America and the Caribbean: A Systematic Review of Randomized Controlled Trials.Journal of primary care & community healthPooled it
- Effects of salt substitution on cumulative blood pressure: a secondary analysis of the SSaSS.European journal of epidemiology · 2025Trial
- Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial.Nature medicine · 2023Trial
- A randomized, double-blind clinical trial to evaluate the blood pressure lowing effect of low-sodium salt substitution on middle-aged and elderly hypertensive patients with different plasma renin concentrations.Journal of clinical hypertension (Greenwich, Conn.) · 2022Trial
- [Potassium substitution: is replacing sodium with potassium-enriched salts beneficial?]Innere Medizin (Heidelberg, Germany) · 2026Review
- The kidney distal tubule potassium switch, modern diet and hypertension.Nature reviews. Nephrology · 2026Review
- Lifetime health benefits, costs, and cost-effectiveness of salt substitution for stroke survivors in China: a microsimulation modeling study.The Lancet regional health. Western Pacific · 2026Article
- Blood Pressure Reduction Effects of Salt Substitutes in Different Application Settings A Meta-Analysis of Randomized Controlled Trials.JACC. Asia · 2026Article
- Sodium reduction and salt substitutes: impact on blood pressure and recurrent stroke.Current opinion in cardiology · 2026Review
- Potassium and the kidney.Nature reviews. Nephrology · 2026Review
- Bridging the Gap in Racial/Ethnic Disparities: Perspectives from the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline.Current hypertension reports · 2026Review
- Standard and Non-standard Cardiovascular Risk Factors in Ischemic Heart Disease and Atherosclerotic Cardiovascular Disease: A Clinical Review.Internal medicine (Tokyo, Japan) · 2026Review
41 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (-2.17, -0.41)) in systolic and 0.76 mm Hg (95% CI (-1.39, -0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, -0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.