Compound ion salt, a novel low-sodium salt substitute: from animal study to community-based population trial.
BACKGROUND
Salt restriction, an important approach for primary and secondary prevention of hypertension, is undermined by unsatisfactory adherence. A salt-restriction study tested the efficacy and safety of a compound ion salt (CISalt) with low sodium content in an animal model and in a community-based population.


METHODS
In part 1, 8-week-old male spontaneously hypertensive rats (SHRs) were fed 1% CISalt in the study group and 8% or 1% normal salt (NSalt) in controls (n = 10 each) for 12 weeks. Blood pressure (BP) and urinary electrolytes were measured every 3 weeks. After 12 weeks, collagen deposition in the heart and kidney and the levels of angiotensin II (Ang II) and nitric oxide (NO) in plasma and renal cortex were measured. In part 2, a single-blind, randomized, 6-month controlled trial with CISalt was conducted in 248 persons (age >or=65 years) in 10 rural communities. Plasma renin activity and Ang II were included in blood and urinary measures at baseline and 6 months.


RESULTS
Reduced BP urinary protein excretion and reduced collagen in the heart and kidneys were significantly different in animals fed CISalt compared to controls. In human studies, at 6 months, mean systolic BP (SBP) was decreased by 9.6 mm Hg (95% confidence interval (CI): 13.1 to 6.1, P < 0.001) and diastolic BP (DBP) by 5.3 mm Hg (95% CI: 7.9 to 2.6, P < 0.001), respectively, compared to controls; urinary sodium excretion also decreased by 67.4 mmol/24 h (95% CI: 84.8 to 50.0, P < 0.001), and plasma renin activity was slightly increased by 0.19 ng/ml/h (95% CI: 0.04-0.33, P = 0.013). No adverse cardiovascular events were reported.


CONCLUSIONS
In these studies, CISalt lowered BP and showed end-organ protection in hypertensive animals and BP reduction in humans. CISalt appears to be a safe and acceptable strategy to reduce BP.
Zhou
Xin
X
Institute of Cardiovascular Disease and Division of Cardiology, Pingjin Hospital, Medical College of the Chinese People's Armed Police Forces, Tianjin, China.
Liu
Jun-Xiang
JX
Shi
Rui
R
Yang
Ning
N
Song
Dong-Lin
DL
Pang
Wei
W
Li
Yu-Ming
YM
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D002119:Calcium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D019355:Calcium Citrate / Q000009:adverse effects / Q000627:therapeutic use; D004573:Electrolytes / Q000652:urine; D005260:Female; D005492:Folic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011189:Potassium Chloride / Q000009:adverse effects / Q000627:therapeutic use*; D051381:Rats; D011918:Rats, Inbred SHR; D012965:Sodium Chloride / Q000009:adverse effects / Q000627:therapeutic use*
D004573:Electrolytes; D012965:Sodium Chloride; D011189:Potassium Chloride; D005492:Folic Acid; D002119:Calcium Carbonate; D019355:Calcium Citrate