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The Salt Substitute and Stroke Study (SSaSS) recently reported beneficial effects of a potassium-enriched salt on cardiovascular outcomes and death (NEJM JW Gen Med Aug 30 2021 and N Engl J Med 2021; 385:1067). The investigators had provided potassium-enriched salt to villagers in rural China with instructions to replace all use of regular salt. To put the trial in perspective and to guide future implementation, it is important to determine the extent to which participants replaced regular salt with the potassium-enriched salt.
Based on urine samples from a subgroup of participants during the 5-year follow-up, the potassium-enriched salt group had a mean increase in 24-hour urinary potassium excretion of 0.80 g/day, equaling consumption of 8…