Evidence map›Paper›PMID 37919742›Full record

Trial reportBMC medicine2023

Experience with 2 years' intervention to progressively reduce salt supply to kitchens in elderly care facilities-challenges and further research: post hoc analysis of the DECIDE-Salt randomized clinical trial.

Yifang Yuan, Aoming Jin, Peifen Duan, La'e Cao, Hongxia Wang, Senke Hu, Jiayu Li, Xiangxian Feng, Qianku Qiao, Hui Zhang and 12 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03290716 (Diet, Exercise and Cardiovascular Health - Effect of Salt Substitute and Stepwise Salt Supply Control in Reducing Blood Pressure in the Elderly in Nursing Homes in China), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03290716 nacompletednot on this map

Diet, Exercise and Cardiovascular Health - Effect of Salt Substitute and Stepwise Salt Supply Control in Reducing Blood Pressure in the Elderly in Nursing Homes in China: a Factorial Cluster-randomized Controlled Trial

TypeinterventionalSponsorPeking UniversityRan2017 to 2021Enrolled1,612ConditionsBlood PressureArmsSS, SSSC
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 7 institutions in 3 countries.

Yifang Yuan *Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
Aoming Jin *Peking University Clinical Research Center, Peking University First Hospital, Haidian District, 38 Xueyuan Road, Beijing, China.
Peifen DuanChangzhi Medical College, Shanxi, China.
La'e CaoYangcheng Ophthalmic Hospital, Shanxi, China.
Hongxia WangDepartment of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Hohhot, Inner Mongolia, China.
Senke HuDepartment of Public Health, Xi'an Jiaotong University, Shaanxi, China.
Jiayu LiPeking University Clinical Research Center, Peking University First Hospital, Haidian District, 38 Xueyuan Road, Beijing, China.
Xiangxian FengChangzhi Medical College, Shanxi, China.
Qianku QiaoYangcheng Ophthalmic Hospital, Shanxi, China.
Hui ZhangDepartment of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Hohhot, Inner Mongolia, China.
Ruijuan ZhangDepartment of Public Health, Xi'an Jiaotong University, Shaanxi, China.
Huijuan LiPeking University Clinical Research Center, Peking University First Hospital, Haidian District, 38 Xueyuan Road, Beijing, China.
Pei GaoDepartment of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
Gaoqiang XiePeking University Clinical Research Center, Peking University First Hospital, Haidian District, 38 Xueyuan Road, Beijing, China.
Jianhui YuanChangzhi Medical College, Shanxi, China.
Lili ChengYangcheng Ophthalmic Hospital, Shanxi, China.
Sujuan WangDepartment of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Hohhot, Inner Mongolia, China.
Wenyi NiuDepartment of Social Medicine and Health Education, Peking University School of Public Health, Beijing, China.
Paul ElliottSchool of Public Health, Faculty of Medicine, Imperial College London, London, UK.
Runlin GaoDepartment of Cardiology, Fuwai Hospital, Peking Union Medical College, Beijing, China.
Darwin LabartheFeinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Yangfeng WuDepartment of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China. wuyf@bjmu.edu.cn.ORCID 0000-0002-4451-1932
Peking University · CNChangzhi Medical College · CNInner Mongolia Comprehensive Disease Prevention and Control Center · CNXi'an Jiaotong University · CNBritish Heart Foundation · GBChinese Academy of Medical Sciences & Peking Union Medical College · CNNorthwestern University · US

Funding

Medical Research Council MR/S019669/1
6 · The paper itself

Abstract

backgroundProgressive reduction of sodium intake is an attractive approach for addressing excessive salt intake, but evidence for this strategy in real practice is limited. We aimed to determine the feasibility, effectiveness, and safety of a progressive sodium intake reduction intervention in real-world setting.

methodsWe randomized 48 residential elderly care facilities in China, with 1612 participants aged 55 years and older, to either progressive reduction (PR, 24 facilities) or no reduction (NR, 24 facilities) of the supply of study salt to the kitchens of these facilities for 2 years. The primary efficacy outcome was systolic blood pressure (SBP) at any scheduled follow-up visit. Secondary efficacy outcomes included diastolic blood pressure (DBP) at any scheduled follow-up visit, and major adverse cardiovascular events (comprising non-fatal stroke, non-fatal myocardial infarction, hospitalized non-fatal heart failure, or vascular death) and total mortality. The perception of food saltiness, the addition of out-of-study salt in meals, and 24-h urinary sodium excretion were used as process indicators.

resultsPre-specified analysis per randomization found no effect of the intervention on the 2-year overall mean systolic and diastolic blood pressure (SBP, DBP) and any other outcomes. However, post hoc analysis showed that the intervention effect on blood pressure varied over multiple follow-up visits (p for interaction < 0.046) and presented favorable differences at the 24-month visit (SBP =  - 3.0 mmHg, 95%CI =  - 5.6, - 0.5; p = 0.020; DBP =  - 2.0 mmHg, 95%CI - 3.4, - 0.63; p = 0.004). The effect on 24-h sodium was non-significant (- 8.4 mmol, 95%CI =  - 21.8 to 4.9, p = 0.216), though fewer participants with NR than with PR reported food tasting bland (odds ratio 0.46; 95%CI 0.29 to 0.73; p = 0.001). Reporting of bland food taste and other process measures indicated that intervention delivery and adherence were not fully achieved as designed.

conclusionsThe experience of this real-world study demonstrated that achieving acceptability and sustainability of the progressive sodium intake reduction strategy among older adults was challenging, but it has shown potential for effectiveness in these and potentially other residential settings if the lessons of DECIDE-Salt are applied in further studies.

trial registrationClinicalTrials.gov (NCT03290716).

Indexed as

HypertensionSodium Chloride, DietaryAgedBlood PressureHumansMiddle AgedSodium Chloride, DietaryBlood pressureCardiovascular diseaseRandomized trialSalt reductionSodium intake

Identifiers

PMID37919742
PMCPMC10623877
OpenAlexW4388249134

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.