Subgroup analyses showed smaller sample s reporting larger effect sizes ; intervention lasting less than 6 months showed larger effect sizes and intention-to-treat analysis showed smaller effect sizes Lifestyle interventions may be of value in preventing and reducing blood pressure in LMICs .
Despite the overwhelming evidence supporting the effectiveness of antihypertensive medication , hypertension remains poorly controlled in low and middle-income countries ( LMICs ) .
Effects of salt substitute on pulse wave analysis among individuals at high cardiovascular risk in rural China: a randomized controlled trial
Reduced-sodium , increased-potassium salt substitutes lower blood pressure but may also have direct effects on vascular structure and arterial function . This study aim ed to test the effects of long-term salt substitution on indices of these outcomes . The China Salt Substitute Study was a r and omized , controlled trial design ed to establish the effects of salt substitute ( 65 % sodium chloride , 25 % potassium chloride , 10 % magnesium sulfate ) compared with regular salt ( 100 % sodium chloride ) on blood pressure among 600 high-risk individuals living in six rural areas in northern China over a 12-month intervention period . Data on central aortic blood pressure , aortic pressure augmentation ( AUG ) , augmentation index ( AIx ) , the differences of the peak of first and baseline waves ( P1–P0 ) and pulse wave reflection time ( RT ) were collected at r and omization and at the completion of follow-up in 187 participants using the Sphygmocor pulse wave analysis system . Mean baseline blood pressure was 150.1/91.4 mm Hg , mean age was 58.4 years , 41 % were male and three quarters had a history of vascular disease . After 12 months of intervention , there were significant net reductions in peripheral ( 7.4 mm Hg , P=0.009 ) and central ( 6.9 mm Hg , P=0.011 ) systolic blood pressure levels and central pulse pressure ( 4.5 mm Hg , P=0.012 ) and correspondingly there was a significant net reduction in P1–P0 ( 3.0 mm Hg , P=0.007 ) , borderline significant net reduction in AUG ( 1.5 mm Hg , P=0.074 ) and significant net increase in RT ( 2.59 ms , P=0.001 ) . There were no detectable reductions in peripheral ( 2.8 mm Hg , P=0.14 ) or central ( 2.4 mm Hg , P=0.13 ) diastolic blood pressure levels or AIx ( 0.06 % , P=0.96 ) . In conclusion , over the 12-month study period the salt substitute significantly reduced not only peripheral and central systolic blood pressure but also reduced arterial stiffness
Subgroup analyses showed smaller sample s reporting larger effect sizes ; intervention lasting less than 6 months showed larger effect sizes and intention-to-treat analysis showed smaller effect sizes Lifestyle interventions may be of value in preventing and reducing blood pressure in LMICs .
Despite the overwhelming evidence supporting the effectiveness of antihypertensive medication , hypertension remains poorly controlled in low and middle-income countries ( LMICs ) .