Impact of Salt Substitute and Stepwise Reduction of Salt Supply on Blood Pressure in Residents in Senior Residential Facilities

Design and Rationale of the DECIDE-Salt Trial

This paper discusses a significant cluster randomized trial aimed at evaluating the effects of sodium reduction strategies on older adults in northern China. 

High sodium intake has been recognized as a primary dietary risk factor for mortality and morbidity amongst older adults. 

The research involved 48 senior residential facilities in Northern China, randomly assigning them to 1 of 4 groups. These groups are:

• Stepwise salt supply control (SSSC) strategy: 5-10% of the study’s salt supply in institutional kitchens was reduced every 3 months.
• Salt substitute (SS) strategy: where normal salt was replaced with a salt substitute.
• Combination of both SSSC and SS strategies
• Neither intervention

This 2-year intervention was closely monitored with follow ups conducted every 6 months. The primary focus of the study is to observe change in systolic blood pressure (SBP) from baseline to the 24-month mark. Secondary outcomes monitored included the incidence of hyperkalemia, hyponatremia, cardiovascular events, and mortality. 

Total of 1606 participants with the mean age of 71 years, and 76% male were recruited.

For further reading: https://www.sciencedirect.com/science/article/abs/pii/S0002870320301599?fr=RR-2&ref=pdf_download&rr=859bcae2295138ab