Deans' stroke musings: Salt Substitution and Recurrent Stroke and DeathA Randomized Clinical Trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, February 6, 2025

Salt Substitution and Recurrent Stroke and DeathA Randomized Clinical Trial

Ask your doctor to clarify if this substitute would help for the amount of salt you are using at home.

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home. This research in China might not be transferable to your needs.

But this:

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

The latest here:

Salt Substitution and Recurrent Stroke and DeathA Randomized Clinical Trial

Key Points

Question Does the use of a reduced-sodium, added-potassium salt substitute vs regular salt decrease the risk of stroke recurrence and death in patients with a history of stroke?

Findings In this prespecified subgroup analysis of the Salt Substitute and Stroke Study (SSaSS) trial involving 15 249 patients with stroke, the use of a salt substitute led to a 14% reduction in the risk of recurrent stroke and a 12% reduction in mortality.

Meaning Results suggest that salt substitution significantly reduced the risks of stroke recurrence and death and is a novel and practical therapeutic option for patients with stroke.

Abstract

Importance The direct effect of consumption of salt substitutes on recurrent stroke and mortality among patients with stroke remains unclear.

Objective To evaluate the effects of salt substitutes vs regular salt on the incidence of recurrent stroke and mortality among patients with stroke.

Design, Setting, and Participants The Salt Substitute and Stroke Study (SSaSS), an open-label, cluster randomized clinical trial, was conducted in 600 northern Chinese villages (clusters). Patients who self-reported a hospital diagnosis of stroke were included in this prespecified subgroup analysis. Data were analyzed from November 2023 to August 2024.

Interventions Participants were assigned to use either a salt substitute, consisting of 75% sodium chloride and 25% potassium chloride by mass, or regular salt.

Main Outcomes and Measures The primary outcome was recurrent stroke.

Results After excluding 5746 persons without a baseline history of stroke, 15 249 patients with stroke (mean [SD] age, 64.1 [8.8] years; 6999 [45.9%] female; 8250 male [54.1%]) were included. Over a median (IQR) follow-up of 61.2 (60.9-61.6) months, the mean difference in systolic blood pressure was −2.05 mm Hg (95% CI, −3.03 to −1.08 mm Hg). A total of 2735 recurrent stroke events (691 fatal and 2044 nonfatal) and 3242 deaths were recorded. Recurrent stroke was significantly lower in the salt substitute vs regular salt group (rate ratio [RR], 0.86; 95% CI, 0.77-0.95; P = .005), with larger effects on hemorrhagic stroke (relative reduction, 30%; P = .002). Death rates were also significantly lower (RR, 0.88; 95% CI, 0.82-0.96; P = .003), with larger effects on stroke-related deaths (relative reduction 21%; P = .01). No significant difference was observed for hyperkalemia (RR, 1.01; 95% CI, 0.74-1.38; P = .96).

Conclusions and Relevance Results of this cluster trial demonstrate that salt substitution was safe, along with reduced risks of stroke recurrence and death, which underscores large health gains from scaling up this low-cost intervention among patients with stroke.

Trial Registration ClinicalTrials.gov Identifier: NCT02092090