Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study
AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and...
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| Veröffentlicht in: | BMJ (Online) 2020-04, Vol.369, p.m824 |
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| creator | Marklund, Matti Singh, Gitanjali Greer, Raquel Cudhea, Frederick Matsushita, Kunihiro Micha, Renata Brady, Tammy Zhao, Di Huang, Liping Tian, Maoyi Cobb, Laura Neal, Bruce Appel, Lawrence J Mozaffarian, Dariush Wu, Jason H Y |
| description | AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and specifically individuals with chronic kidney disease (about 17 million people).InterventionsComparative risk assessment models were used to estimate the effects of a nationwide intervention to replace discretionary dietary salt with potassium enriched salt substitutes (20-30% potassium chloride). The models incorporated existing data and corresponding uncertainties from randomised trials, the China National Survey of Chronic Kidney Disease, the Global Burden of Disease Study, and the Chronic Kidney Disease Prognosis Consortium.Main outcome measuresAverted deaths from cardiovascular disease, non-fatal events, and disability adjusted life years from a reduction in blood pressure were estimated after implementation of potassium enriched salt substitution. In individuals with chronic kidney disease, additional deaths from cardiovascular disease related to hyperkalaemia from increased intake of potassium were calculated. The net effects on deaths from cardiovascular disease were estimated as the difference and ratio of averted and additional deaths from cardiovascular disease.ResultsNationwide implementation of potassium enriched salt substitution could prevent about 461 000 (95% uncertainty interval 196 339 to 704 438) deaths annually from cardiovascular disease, corresponding to 11.0% (4.7% to 16.8%) of annual deaths from cardiovascular disease in China; 743 000 (305 803 to 1 273 098) non-fatal cardiovascular events annually; and 7.9 (3.3 to 12.9) million disability adjusted life years related to cardiovascular disease annually. The intervention could potentially produce an estimated 11 000 (6422 to 16 562) additional deaths related to hyperkalaemia in individuals with chronic kidney disease. The net effect would be about 450 000 (183 699 to 697 084) fewer deaths annually from cardiovascular disease in the overall population and 21 000 (1928 to 42 926) fewer deaths in individuals with chronic kidney disease. In deterministic sensitivity analyses, with changes to key model inputs and assumptions, net benefits were consistent in the total population and in individuals with chronic kidney disease, with averted deaths outweighing additional deaths.ConclusionsNationwide |
| doi_str_mv | 10.1136/bmj.m824 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_pubmed_primary_32321724</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2393508444</sourcerecordid><originalsourceid>FETCH-LOGICAL-b465t-fdec9547f14cd913697187007b30789251c80a187757b73ac1dcf3ebef8e479c3</originalsourceid><addsrcrecordid>eNp1kd9OHCEYxYlpU4016RMYEm964VoYmGXwwsSsVpuYeKO9JQwwO2xnYOWPG1-gz12ma61eeAWB33fOd3IA-ILRCcZk_q0dVydjU9EdsIdZPZ_hhpAPr-674CDGFUKoIqzh8_oT2CUVqTCr6B74fRmTHWUyGq79Og8yWe_gxmoDW-NMZ1OE0mkYbPwVoXVw0Vsnoe_g4DcmWLeE0WubR5j64POyLzJJxji9GBes6otylEOCMbfFKuXJ4BSOXpth-Duesn76DD52cojm4PncB_ffL-8W17Ob26sfi_ObWUvndZp12iheU9ZhqjQv4TnDDUOItQSVbFWNVYNkeWI1axmRCmvVEdOarjGUcUX2wfFWN27MOrdiHUr48CS8tOLC_jwXPixFzoISwhkv-NkWL-xotDIuBTm8mXr742wvlv5RMMzLVnUROHoWCP4hm5jEyufgSkRREU5q1FBKC_V1S6ngYwyme3HASEwdi9KxmDou6OHrjV7Af43-d5xG3pX5A6WIscg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2393508444</pqid></control><display><type>article</type><title>Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study</title><source>MEDLINE</source><source>SWEPUB Freely available online</source><source>JSTOR Archive Collection A-Z Listing</source><creator>Marklund, Matti ; Singh, Gitanjali ; Greer, Raquel ; Cudhea, Frederick ; Matsushita, Kunihiro ; Micha, Renata ; Brady, Tammy ; Zhao, Di ; Huang, Liping ; Tian, Maoyi ; Cobb, Laura ; Neal, Bruce ; Appel, Lawrence J ; Mozaffarian, Dariush ; Wu, Jason H Y</creator><creatorcontrib>Marklund, Matti ; Singh, Gitanjali ; Greer, Raquel ; Cudhea, Frederick ; Matsushita, Kunihiro ; Micha, Renata ; Brady, Tammy ; Zhao, Di ; Huang, Liping ; Tian, Maoyi ; Cobb, Laura ; Neal, Bruce ; Appel, Lawrence J ; Mozaffarian, Dariush ; Wu, Jason H Y</creatorcontrib><description>AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and specifically individuals with chronic kidney disease (about 17 million people).InterventionsComparative risk assessment models were used to estimate the effects of a nationwide intervention to replace discretionary dietary salt with potassium enriched salt substitutes (20-30% potassium chloride). The models incorporated existing data and corresponding uncertainties from randomised trials, the China National Survey of Chronic Kidney Disease, the Global Burden of Disease Study, and the Chronic Kidney Disease Prognosis Consortium.Main outcome measuresAverted deaths from cardiovascular disease, non-fatal events, and disability adjusted life years from a reduction in blood pressure were estimated after implementation of potassium enriched salt substitution. In individuals with chronic kidney disease, additional deaths from cardiovascular disease related to hyperkalaemia from increased intake of potassium were calculated. The net effects on deaths from cardiovascular disease were estimated as the difference and ratio of averted and additional deaths from cardiovascular disease.ResultsNationwide implementation of potassium enriched salt substitution could prevent about 461 000 (95% uncertainty interval 196 339 to 704 438) deaths annually from cardiovascular disease, corresponding to 11.0% (4.7% to 16.8%) of annual deaths from cardiovascular disease in China; 743 000 (305 803 to 1 273 098) non-fatal cardiovascular events annually; and 7.9 (3.3 to 12.9) million disability adjusted life years related to cardiovascular disease annually. The intervention could potentially produce an estimated 11 000 (6422 to 16 562) additional deaths related to hyperkalaemia in individuals with chronic kidney disease. The net effect would be about 450 000 (183 699 to 697 084) fewer deaths annually from cardiovascular disease in the overall population and 21 000 (1928 to 42 926) fewer deaths in individuals with chronic kidney disease. In deterministic sensitivity analyses, with changes to key model inputs and assumptions, net benefits were consistent in the total population and in individuals with chronic kidney disease, with averted deaths outweighing additional deaths.ConclusionsNationwide potassium enriched salt substitution in China was estimated to result in a substantial net benefit, preventing around one in nine deaths from cardiovascular disease overall. Taking account of the risks of hyperkalaemia, a substantial net benefit was also estimated for individuals with chronic kidney disease.</description><identifier>ISSN: 1756-1833</identifier><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.m824</identifier><identifier>PMID: 32321724</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Adults ; Age ; Aged ; Blood Pressure ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - mortality ; China - epidemiology ; Chloride ; Cooking ; Diet, Sodium-Restricted ; Estimates ; Female ; Health risk assessment ; Humans ; Hyperkalemia - chemically induced ; Hyperkalemia - epidemiology ; Hypertension - diet therapy ; Hypertension - epidemiology ; Kidney diseases ; Male ; Middle Aged ; Morbidity ; Myocardial Ischemia - epidemiology ; Myocardial Ischemia - mortality ; Population studies ; Potassium ; Potassium Chloride ; Pressure distribution ; Quality-Adjusted Life Years ; Renal Insufficiency, Chronic - epidemiology ; Risk Assessment ; Risk factors ; Salt ; Sensitivity analysis ; Sodium Chloride, Dietary ; Stroke ; Stroke - epidemiology ; Stroke - mortality</subject><ispartof>BMJ (Online), 2020-04, Vol.369, p.m824</ispartof><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. BMJ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 BMJ</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b465t-fdec9547f14cd913697187007b30789251c80a187757b73ac1dcf3ebef8e479c3</citedby><cites>FETCH-LOGICAL-b465t-fdec9547f14cd913697187007b30789251c80a187757b73ac1dcf3ebef8e479c3</cites><orcidid>0000-0002-3320-796X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,552,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32321724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-433979$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Marklund, Matti</creatorcontrib><creatorcontrib>Singh, Gitanjali</creatorcontrib><creatorcontrib>Greer, Raquel</creatorcontrib><creatorcontrib>Cudhea, Frederick</creatorcontrib><creatorcontrib>Matsushita, Kunihiro</creatorcontrib><creatorcontrib>Micha, Renata</creatorcontrib><creatorcontrib>Brady, Tammy</creatorcontrib><creatorcontrib>Zhao, Di</creatorcontrib><creatorcontrib>Huang, Liping</creatorcontrib><creatorcontrib>Tian, Maoyi</creatorcontrib><creatorcontrib>Cobb, Laura</creatorcontrib><creatorcontrib>Neal, Bruce</creatorcontrib><creatorcontrib>Appel, Lawrence J</creatorcontrib><creatorcontrib>Mozaffarian, Dariush</creatorcontrib><creatorcontrib>Wu, Jason H Y</creatorcontrib><title>Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and specifically individuals with chronic kidney disease (about 17 million people).InterventionsComparative risk assessment models were used to estimate the effects of a nationwide intervention to replace discretionary dietary salt with potassium enriched salt substitutes (20-30% potassium chloride). The models incorporated existing data and corresponding uncertainties from randomised trials, the China National Survey of Chronic Kidney Disease, the Global Burden of Disease Study, and the Chronic Kidney Disease Prognosis Consortium.Main outcome measuresAverted deaths from cardiovascular disease, non-fatal events, and disability adjusted life years from a reduction in blood pressure were estimated after implementation of potassium enriched salt substitution. In individuals with chronic kidney disease, additional deaths from cardiovascular disease related to hyperkalaemia from increased intake of potassium were calculated. The net effects on deaths from cardiovascular disease were estimated as the difference and ratio of averted and additional deaths from cardiovascular disease.ResultsNationwide implementation of potassium enriched salt substitution could prevent about 461 000 (95% uncertainty interval 196 339 to 704 438) deaths annually from cardiovascular disease, corresponding to 11.0% (4.7% to 16.8%) of annual deaths from cardiovascular disease in China; 743 000 (305 803 to 1 273 098) non-fatal cardiovascular events annually; and 7.9 (3.3 to 12.9) million disability adjusted life years related to cardiovascular disease annually. The intervention could potentially produce an estimated 11 000 (6422 to 16 562) additional deaths related to hyperkalaemia in individuals with chronic kidney disease. The net effect would be about 450 000 (183 699 to 697 084) fewer deaths annually from cardiovascular disease in the overall population and 21 000 (1928 to 42 926) fewer deaths in individuals with chronic kidney disease. In deterministic sensitivity analyses, with changes to key model inputs and assumptions, net benefits were consistent in the total population and in individuals with chronic kidney disease, with averted deaths outweighing additional deaths.ConclusionsNationwide potassium enriched salt substitution in China was estimated to result in a substantial net benefit, preventing around one in nine deaths from cardiovascular disease overall. Taking account of the risks of hyperkalaemia, a substantial net benefit was also estimated for individuals with chronic kidney disease.</description><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Blood Pressure</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>China - epidemiology</subject><subject>Chloride</subject><subject>Cooking</subject><subject>Diet, Sodium-Restricted</subject><subject>Estimates</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hyperkalemia - chemically induced</subject><subject>Hyperkalemia - epidemiology</subject><subject>Hypertension - diet therapy</subject><subject>Hypertension - epidemiology</subject><subject>Kidney diseases</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Myocardial Ischemia - epidemiology</subject><subject>Myocardial Ischemia - mortality</subject><subject>Population studies</subject><subject>Potassium</subject><subject>Potassium Chloride</subject><subject>Pressure distribution</subject><subject>Quality-Adjusted Life Years</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Salt</subject><subject>Sensitivity analysis</subject><subject>Sodium Chloride, Dietary</subject><subject>Stroke</subject><subject>Stroke - epidemiology</subject><subject>Stroke - 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Matti</creator><creator>Singh, Gitanjali</creator><creator>Greer, Raquel</creator><creator>Cudhea, Frederick</creator><creator>Matsushita, Kunihiro</creator><creator>Micha, Renata</creator><creator>Brady, Tammy</creator><creator>Zhao, Di</creator><creator>Huang, Liping</creator><creator>Tian, Maoyi</creator><creator>Cobb, Laura</creator><creator>Neal, Bruce</creator><creator>Appel, Lawrence J</creator><creator>Mozaffarian, Dariush</creator><creator>Wu, Jason H Y</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group 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population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study</title><author>Marklund, Matti ; Singh, Gitanjali ; Greer, Raquel ; Cudhea, Frederick ; Matsushita, Kunihiro ; Micha, Renata ; Brady, Tammy ; Zhao, Di ; Huang, Liping ; Tian, Maoyi ; Cobb, Laura ; Neal, Bruce ; Appel, Lawrence J ; Mozaffarian, Dariush ; Wu, Jason H Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b465t-fdec9547f14cd913697187007b30789251c80a187757b73ac1dcf3ebef8e479c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Blood Pressure</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>China - epidemiology</topic><topic>Chloride</topic><topic>Cooking</topic><topic>Diet, Sodium-Restricted</topic><topic>Estimates</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hyperkalemia - chemically induced</topic><topic>Hyperkalemia - epidemiology</topic><topic>Hypertension - diet therapy</topic><topic>Hypertension - epidemiology</topic><topic>Kidney diseases</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Myocardial Ischemia - epidemiology</topic><topic>Myocardial Ischemia - mortality</topic><topic>Population studies</topic><topic>Potassium</topic><topic>Potassium Chloride</topic><topic>Pressure distribution</topic><topic>Quality-Adjusted Life Years</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Salt</topic><topic>Sensitivity analysis</topic><topic>Sodium Chloride, Dietary</topic><topic>Stroke</topic><topic>Stroke - epidemiology</topic><topic>Stroke - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marklund, Matti</creatorcontrib><creatorcontrib>Singh, Gitanjali</creatorcontrib><creatorcontrib>Greer, Raquel</creatorcontrib><creatorcontrib>Cudhea, Frederick</creatorcontrib><creatorcontrib>Matsushita, Kunihiro</creatorcontrib><creatorcontrib>Micha, Renata</creatorcontrib><creatorcontrib>Brady, Tammy</creatorcontrib><creatorcontrib>Zhao, Di</creatorcontrib><creatorcontrib>Huang, Liping</creatorcontrib><creatorcontrib>Tian, Maoyi</creatorcontrib><creatorcontrib>Cobb, Laura</creatorcontrib><creatorcontrib>Neal, Bruce</creatorcontrib><creatorcontrib>Appel, Lawrence J</creatorcontrib><creatorcontrib>Mozaffarian, Dariush</creatorcontrib><creatorcontrib>Wu, Jason H Y</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open 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(Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marklund, Matti</au><au>Singh, Gitanjali</au><au>Greer, Raquel</au><au>Cudhea, Frederick</au><au>Matsushita, Kunihiro</au><au>Micha, Renata</au><au>Brady, Tammy</au><au>Zhao, Di</au><au>Huang, Liping</au><au>Tian, Maoyi</au><au>Cobb, Laura</au><au>Neal, Bruce</au><au>Appel, Lawrence J</au><au>Mozaffarian, Dariush</au><au>Wu, Jason H Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2020-04-22</date><risdate>2020</risdate><volume>369</volume><spage>m824</spage><pages>m824-</pages><issn>1756-1833</issn><issn>0959-8138</issn><eissn>1756-1833</eissn><abstract>AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and specifically individuals with chronic kidney disease (about 17 million people).InterventionsComparative risk assessment models were used to estimate the effects of a nationwide intervention to replace discretionary dietary salt with potassium enriched salt substitutes (20-30% potassium chloride). The models incorporated existing data and corresponding uncertainties from randomised trials, the China National Survey of Chronic Kidney Disease, the Global Burden of Disease Study, and the Chronic Kidney Disease Prognosis Consortium.Main outcome measuresAverted deaths from cardiovascular disease, non-fatal events, and disability adjusted life years from a reduction in blood pressure were estimated after implementation of potassium enriched salt substitution. In individuals with chronic kidney disease, additional deaths from cardiovascular disease related to hyperkalaemia from increased intake of potassium were calculated. The net effects on deaths from cardiovascular disease were estimated as the difference and ratio of averted and additional deaths from cardiovascular disease.ResultsNationwide implementation of potassium enriched salt substitution could prevent about 461 000 (95% uncertainty interval 196 339 to 704 438) deaths annually from cardiovascular disease, corresponding to 11.0% (4.7% to 16.8%) of annual deaths from cardiovascular disease in China; 743 000 (305 803 to 1 273 098) non-fatal cardiovascular events annually; and 7.9 (3.3 to 12.9) million disability adjusted life years related to cardiovascular disease annually. The intervention could potentially produce an estimated 11 000 (6422 to 16 562) additional deaths related to hyperkalaemia in individuals with chronic kidney disease. The net effect would be about 450 000 (183 699 to 697 084) fewer deaths annually from cardiovascular disease in the overall population and 21 000 (1928 to 42 926) fewer deaths in individuals with chronic kidney disease. In deterministic sensitivity analyses, with changes to key model inputs and assumptions, net benefits were consistent in the total population and in individuals with chronic kidney disease, with averted deaths outweighing additional deaths.ConclusionsNationwide potassium enriched salt substitution in China was estimated to result in a substantial net benefit, preventing around one in nine deaths from cardiovascular disease overall. Taking account of the risks of hyperkalaemia, a substantial net benefit was also estimated for individuals with chronic kidney disease.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>32321724</pmid><doi>10.1136/bmj.m824</doi><orcidid>https://orcid.org/0000-0002-3320-796X</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_pubmed_primary_32321724 |
| source | MEDLINE; SWEPUB Freely available online; JSTOR Archive Collection A-Z Listing |
| subjects | Adult Adults Age Aged Blood Pressure Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - mortality China - epidemiology Chloride Cooking Diet, Sodium-Restricted Estimates Female Health risk assessment Humans Hyperkalemia - chemically induced Hyperkalemia - epidemiology Hypertension - diet therapy Hypertension - epidemiology Kidney diseases Male Middle Aged Morbidity Myocardial Ischemia - epidemiology Myocardial Ischemia - mortality Population studies Potassium Potassium Chloride Pressure distribution Quality-Adjusted Life Years Renal Insufficiency, Chronic - epidemiology Risk Assessment Risk factors Salt Sensitivity analysis Sodium Chloride, Dietary Stroke Stroke - epidemiology Stroke - mortality |
| title | Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T15%3A10%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Estimated%20population%20wide%20benefits%20and%20risks%20in%20China%20of%20lowering%20sodium%20through%20potassium%20enriched%20salt%20substitution:%20modelling%20study&rft.jtitle=BMJ%20(Online)&rft.au=Marklund,%20Matti&rft.date=2020-04-22&rft.volume=369&rft.spage=m824&rft.pages=m824-&rft.issn=1756-1833&rft.eissn=1756-1833&rft_id=info:doi/10.1136/bmj.m824&rft_dat=%3Cproquest_swepu%3E2393508444%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2393508444&rft_id=info:pmid/32321724&rfr_iscdi=true |