SSaSS(盐替代品和中风研究)表明,使用富含钾的盐可以降低中风的风险,总心血管事件,过早死亡。此处报告了对特定于原因的心脏结果的影响。
■SSaSS是一个非盲区,一项整群随机试验,在20995名已确诊卒中、年龄较大且高血压未控制的中国成年人中,评估了富钾盐与普通盐的效果.使用意向治疗方法和分层泊松回归模型进行事后疗效分析,以调整聚类以获得比率和95%CIs。我们评估了急性冠脉综合征,心力衰竭,心律失常,突然死亡。
■平均4.74年随访,有695例急性冠脉综合征事件,454例心力衰竭事件,230例心律失常事件,记录了1133例猝死。在所有结局中,富钾盐组的事件发生率均较低,但大多数情况下的CI均较宽:急性冠脉综合征(6.32对7.65事件/1000人年;比率,0.80[95%CI,0.65-0.99]);心力衰竭(每1000人年发生9.14对11.32事件;比率,0.88[95%CI,0.60-1.28]);心律失常(4.43对6.20事件/1000人年;比率,0.59[95%CI,0.35-0.98]);猝死(每1000人年发生11.01对11.76事件;比率,0.94[95%CI,0.82-1.07];所有P>0.05,经多重比较校正)。
这些结果表明,使用富含钾的盐更有可能预防心脏疾病,但这些分析的事后性质排除了明确的结论。
■URL:https://www。clinicaltrials.gov;唯一标识符:NCT02092090。
UNASSIGNED: The SSaSS (Salt Substitute and Stroke
Study) has shown that use of a potassium-enriched salt lowers the risk of stroke, total cardiovascular events, and premature death. The effects on cause-specific cardiac outcomes are reported here.
UNASSIGNED: SSaSS was an unblinded, cluster-randomised
trial assessing the effects of potassium-enriched salt compared with regular salt among 20 995 Chinese adults with established stroke and older age and uncontrolled hypertension. Post hoc efficacy analyses were performed using an intention-to-treat method and a hierarchical Poisson regression model adjusting for clustering to obtain rate ratios and 95% CIs. We assessed acute coronary syndrome, heart failure, arrhythmia, and sudden death.
UNASSIGNED: Over a mean 4.74 years follow-up, there were 695 acute coronary syndrome events, 454 heart failure events, 230 arrhythmia events, and 1133 sudden deaths recorded. The rates of events were lower in potassium-enriched salt group for all outcomes but CIs were wide for most: acute coronary syndrome (6.32 versus 7.65 events per 1000 person-years; rate ratio, 0.80 [95% CI, 0.65-0.99]); heart failure (9.14 versus 11.32 events per 1000 person-years; rate ratio, 0.88 [95% CI, 0.60-1.28]); arrhythmia (4.43 versus 6.20 events per 1000 person-years; rate ratio, 0.59 [95% CI, 0.35-0.98]); and sudden death (11.01 versus 11.76 events per 1000 person-years; rate ratio, 0.94 [95% CI, 0.82-1.07]; all P>0.05 with adjustment for multiple comparisons).
UNASSIGNED: These results suggest that use of potassium-enriched salt is more likely to prevent than cause cardiac disease but the post hoc nature of these analyses precludes definitive conclusions.
UNASSIGNED: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02092090.