Experience with 2 years’ intervention to progressively reduce salt supply to kitchens in elderly care facilities—challenges and further research: post hoc analysis of the DECIDE-Salt randomized clinical trial

Autor: Yifang Yuan, Aoming Jin, Peifen Duan, La’e Cao, Hongxia Wang, Senke Hu, Jiayu Li, Xiangxian Feng, Qianku Qiao, Hui Zhang, Ruijuan Zhang, Huijuan Li, Pei Gao, Gaoqiang Xie, Jianhui Yuan, Lili Cheng, Sujuan Wang, Wenyi Niu, Paul Elliott, Runlin Gao, Darwin Labarthe, Yangfeng Wu
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Medicine, Vol 21, Iss 1, Pp 1-11 (2023)
Druh dokumentu: article
ISSN: 1741-7015
DOI: 10.1186/s12916-023-03130-z
Popis: Abstract Background Progressive reduction of sodium intake is an attractive approach for addressing excessive salt intake, but evidence for this strategy in real practice is limited. We aimed to determine the feasibility, effectiveness, and safety of a progressive sodium intake reduction intervention in real-world setting. Methods We randomized 48 residential elderly care facilities in China, with 1612 participants aged 55 years and older, to either progressive reduction (PR, 24 facilities) or no reduction (NR, 24 facilities) of the supply of study salt to the kitchens of these facilities for 2 years. The primary efficacy outcome was systolic blood pressure (SBP) at any scheduled follow-up visit. Secondary efficacy outcomes included diastolic blood pressure (DBP) at any scheduled follow-up visit, and major adverse cardiovascular events (comprising non-fatal stroke, non-fatal myocardial infarction, hospitalized non-fatal heart failure, or vascular death) and total mortality. The perception of food saltiness, the addition of out-of-study salt in meals, and 24-h urinary sodium excretion were used as process indicators. Results Pre-specified analysis per randomization found no effect of the intervention on the 2-year overall mean systolic and diastolic blood pressure (SBP, DBP) and any other outcomes. However, post hoc analysis showed that the intervention effect on blood pressure varied over multiple follow-up visits (p for interaction
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