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 ) .
Salt substitution: a low-cost strategy for blood pressure control among rural Chinese. A randomized, controlled trial
Objective Dietary sodium and potassium consumption is associated with  blood pressure levels . The objective of this study was to define a practical and low-cost method for the control of blood pressure by modification of these dietary cations in rural Chinese . Methods This study was a double-blind , r and omized , controlled trial design ed to establish the long-term effects of a reduced-sodium , high-potassium salt substitute ( 65 % sodium chloride , 25 % potassium chloride , 10 % magnesium sulphate ) compared to normal salt ( 100 % sodium chloride ) on blood pressure among high-risk individuals . Following a 4-week run-in period on salt substitute , participants were r and omly assigned to replace their household salt with either the study salt substitute or normal salt for a 12-month period . Results The mean age of the 608 r and omized participants was 60 years and 56 % of them were female . Sixty-four percent had a history of vascular disease and 61 % were taking one or more blood pressure-lowering drugs at entry .  Mean baseline blood pressure was 159/93 mmHg ( SD 26/14 ) . The mean overall difference in systolic blood pressure between r and omized groups was 3.7 mmHg ( 95 % confidence interval 1.6–5.9 , P < 0.001 ) . There was strong evidence that the magnitude of this reduction increased over time ( P = 0.001 ) with the maximum net reduction of 5.4 mmHg ( 2.3–8.5 ) achieved at 12 months . There were no detectable effects on diastolic blood pressure . Conclusion Salt substitution produced a substantial and sustained systolic blood pressure reduction in this population , and should be actively promoted as a low-cost alternate or adjunct to drug therapy for people consuming significant quantities of salt
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 ) .