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. 2022 Aug 10;2022(8):CD015207. doi: 10.1002/14651858.CD015207

6. Comparison 1: Overview of Synthesis and Included Studies (OSIS).

Study name (year) Study design (individual vs stepped‐wedge vs cluster‐randomised [and unit of randomisation, if applicable]) Country of conduct Overall risk of bias (arranged low to high) Key details of intervention (% KCl, LSSS (implementation [discretionary, non‐discretionary, both], quantity, provided or purchased, co‐interventions [education, advice]) Key details of the comparator (implementation [discretionary, non‐discretionary, both], quantity, provided or household supply, co‐interventions [education, advice]) Population (No. of participants randomised [intervention/control], age, gender, hypertensive status, antihypertensive medication use, BMI) Outcome domains with available data (synthesis method/metric) Specific outcomes measure Time point of measurement
Allaert 2017 Individually randomised France Low No KCl content in LSSS (97% NaCl and 3% chitosan)
 
Discretionary use to a maximum of 3 g per day 
 
300 g provided
 
Participants not to change their dietary, physical activity, smoking habits during study period
Regular salt
 
 
 
Discretionary use to a maximum of 3 g per day 
 
300 g provided 
 
Participants not to change their dietary, physical activity, smoking habits during study period
22/19
 
51 (16) years
 
Male, %: 51.2
 
Pre‐hypertensive
 
None
 
NR
Change in blood pressure
 
Cardiovascular events
 
Change in blood potassium
 
Adverse events
1. Change in DBP
2. Change in SBP
3. Various other cardiovascular events
4. Change in blood potassium
5. Various other adverse events
1. 56 days
2. 56 days
3. ≤ 3 months
4. 56 days
5. ≤ 3 months
CSSS Collaborative Group 2007 Individually randomised China Low 25% KCl LSSS (with 65% NaCl and 10% MgSO4
Discretionary use 
 
Up to 3 kg per month provided for household use
 
Co‐interventions NR
Regular salt
 
 
Discretionary use 
 
Up to 3 kg per month provided for household use
 
Co‐interventions NR
306/302
 
59 (10)/61 (9.7) years
 
Female, %: 54/58 
 
Hypertensive, %: 57/57
 
Use of any antihypertensive medication, %: 61/61 
 
 
26 (3.6)/25(3.9) kg/m2
Change in blood pressure
 
Cardiovascular events
 
Hyperkalaemia
 
Mortality
 
Adverse events
 
1. Change in DBP
2. Change in SBP
3.  Various other cardiovascular events
4. Hyperkalaemia
5. All‐cause mortality
6.  Various other adverse events
1. See Table 7
2. 12 months
3. > 3 to 12 months
4. 12 months
5. > 3 to 12 months
6. > 3 to 12 months
Li 2014 Cluster‐randomised (households) China Low 30% KCl LSSS (KCl 30.0 ± 10.0 %; NaCl 70.0 ± 10.0%;)
 
Discretionary use
 
350 g provided (frequency NR)
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use
 
Own household supply
 
 
Co‐interventions NR
253/263
 
59.3 (11.7)/59.2 (8.7) years
 
Female, %: 50.9/48.7
 
NR
 
NR
 
NR
Change in blood pressure
 
1. Change in DBP
2. Change in SBP
 
1. 2 months
2. 2 months
 
Neal 2021 Cluster‐randomised (villages) China Low 30 ± 10% KCl (with 70 ± 10% NaCl ) 
 
Discretionary use at average intake of 20 g per person per day 
 
Provided regular supply of LSSS to households (up to 20 kg per year for a household with 3 members)
 
Co‐interventions NR
 
Regular salt
 
 
 
Discretionary use 
 
Own household supply
 
Advice about reducing salt intake given at study commencement.
 
10504/10491
 
65.2 (8.5)/ 65.5 (8.5) years
 
Female, %: 49.7
 
Hypertensive, %: 59.4/59.2
 
Any antihypertensive medication, %: 79.9/78.7
 
24.8 (3.6)/24.9 (3.7) kg/m2
Change in blood pressure
 
Cardiovascular events
 
Mortality
 
Hyperkalaemia
 
24‐h urinary excretion
1. Change in DBP
2. Change in SBP
3. Cardiovascular events: non‐fatal stroke
4. Cardiovascular events: non‐fatal acute coronary syndrome
5. Cardiovascular mortality
6. Stroke mortality
7. All‐cause mortality
8. Hyperkalaemia
9. 24‐h urinary sodium excretion
10. 24‐h urinary potassium excretion
1. 60 months
2. 60 months
3. 4.75 years mean follow‐up
4. 4.75 years mean follow‐up
5. 4.75 years mean follow‐up
6. 4.75 years mean follow‐up
7. 4.75 years mean follow‐up
8. 4.75 years mean follow‐up
9. 60 months
10. 60 months
 
 
 
 
Pan 2017 Individually randomised Taiwan Low Two intervention arms: 50% KCl LSSS (with NaCl 50%) or 42.85% KCl LSSS, (with 42.85% NaCl, 14.3% MgSO4) 
 
Discretionary use at approx. 6.5 g per person day
 
1 kg provided at study entry and 3 months, for household use
 
Co‐interventions NR
Regular salt
 
 
 
 
 
Discretionary use at approx. 6.5 g per person per day 
 
1 kg provided at study entry and 3 months, for household use
 
Co‐interventions NR
97/95/99
 
64.4 (9.8)/64.7 (9.9)/ 64.8 (10.3) years
 
Female, %: 42.3/34.7/32.3
 
Hypertensive, %: 56.7/68.4/50.5
 
NR
 
NR
Cardiovascular events
 
Mortality
 
Adverse events
 
1. Cardiovascular events: non‐fatal stroke
2. All‐cause mortality
3. Various other adverse events
 
1. > 3 to 12 months
2. > 3 to 12 months 
3. > 3 to 12 months
Yu 2021 Individually randomised India Low 30% KCl (with 70% NaCl)
 
 
Discretionary use of 20 g per person per day. 
 
Provided up to 5 kg every 3 months for household use
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use of 20 g per person per day 
 
Provided up to 5 kg every 3 months for household use
 
Co‐interventions NR
252/252
 
61.5 (11.1)/ 61.7 (12.9) years
 
Female, %: 58.3/59.2
 
Hypertensive
 
Any hypertensive medication use, %: 97.2/94.4
 
23.1 (4.7)/23.6 (4.2) kg/m2
Change in blood pressure
 
Hyperkalaemia
 
Adverse events
 
24‐h urinary excretion
 
1. Change in DBP
2. Change in SBP
3. Hyperkalaemia
4. Various other adverse events
5. 24‐h urinary sodium excretion
6. 24‐h urinary potassium excretion
1. 3 months
2. 3 months
3. 3 months
4. ≤ 3 months
5. 3 months
6. 3 months
 
Zhao 2014 Individually randomised Tibet Low 25% KCl LSSS (with 65% NaCl and 10% MgSO4)
 
Discretionary use
 
Provided in sufficient amounts for household use
 
Patients with pre‐existing antihypertensive medications not alter their prior regimen
Regular salt
 
 
 
Discretionary use
 
 
Provided in sufficient amounts for household use
 
Patients with pre‐existing antihypertensive medications not alter their prior regimen
141/141
 
62.8 (11.1)/ 63.5 (11.3) years
 
 
Female, %: 60.3/57.4
 
Hypertensive
 
Antihypertensive use in the past month, %: 47.0/50.7
 
23.7 (3.1)/23.6 (3.4) kg/m2
Change in blood pressure
 
Blood pressure control
 
Adverse events
 
 
 
 
 
 
1. Change in DBP
2. Change in SBP
3. Blood pressure control
4. Antihypertensive medication use
5. Various other adverse events
 
1. 3 months
2. 3 months
3. 3 months
4. 3 months
5.  ≤ 3 months
 
Zhou 2009
 
Individually randomised China Low 30% KCl LSSS (with 65% NaCl, calcium, folic acid)
 
Discretionary use
 
3 kg per month provided for household use
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use 
 
3 kg per month provided for household use
 
Co‐interventions NR
62/64
 
67.5 (5.2)/ 65.7 (6.3) years
 
Female, %: 56.5/57.8
 
Hypertensive
 
Any antihypertensive medication use, %: 53.2/54.7
 
25.2 (3.5)/24.9 (3.7)  kg/m2
 
 
57/65
 
68.1 (8.3)/65.4 (4.5) years
 
Female, %: 50.9/55.4
 
Normotensive
 
N/A
 
23.9 (3.2)/23.7 (3.3) kg/m2
Change in blood pressure
 
Cardiovascular events
 
Change in blood glucose
 
Change in blood lipids
 
24‐h urinary excretion
1. Change in DBP
2. Change in SBP
3.  Various other cardiovascular events
4. Change in fasting blood glucose
5. Change in blood triglycerides
6. Change in total blood cholesterol
7. 24‐h urinary sodium excretion
8. 24‐h urinary potassium excretion
1. 6 months
2. 6 months
3 > 3 to 12 months
4. 6 months
5. 6 months
6. 6 months
7. 6 months
8. 6 months
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Allaert 2013 Individually randomised France Unclear No KCl content in LSSS (97% NaCl and 3% chitosan)
 
Discretionary use to a maximum of 3 g per day 
 
Quantity provided NR
 
Lifestyle advice (eating less fat and sugar, avoidance of liquorice) and physical exercise
Sea salt
 
 
 
Discretionary use to a maximum of 3 g per day 
 
Quantity provided NR
 
Lifestyle advice (eating less fat and sugar, avoidance of liquorice) and physical exercise
21/19
 
59.1 (11.6)/ 58.0 (12.7) years
 
Female, %: 61.9/57.9
 
Hypertensive
 
None
 
25.1 (3.8)/27.7 (5.8)  kg/m2
Change in blood pressure
 
Blood pressure control
 
 
 
1. Change in DBP
2. Change in SBP
3. Blood pressure control
 
1. 8 weeks
2. 8 weeks
3. 8 weeks
 
 
 
 
 
Arzilli 1986 Individually randomised Italy Unclear Unknown KCl LSSS 
 
Discretionary use
 
2 g twice daily provided
 
Hospital diet containing 20 mmol Na per day provided
 
Co‐interventions NR
Regular salt
 
Discretionary use
 
2 g twice daily provided
 
Hospital diet containing 20 mmol Na per day provided
 
Co‐interventions NR
10/10
 
28 to 53 years
 
Female, %: 40
 
Hypertensive
 
NR
 
NR
Change in blood pressure
 
 
 
1. Change in DBP
2. Change in SBP
 
1. See Table 7
2. See Table 7
 
 
 
 
 
Bernabe‐Ortiz 2014 Stepped‐wedge (villages) Peru Unclear 25% KCl LSSS (with 75% NaCl)
 
Discretionary use
 
Provision of LSSS via salt supply chain in each village. Social marketing strategy promoting LSSS use
Regular salt
 
 
Discretionary use
 
Normal salt supply chain
2376 (total)
 
43.3 (17.2) years
 
Female, %: 50.4
 
Hypertensive, %: 18.3
 
NR
 
27.2 (4.6) kg/m2
Change in blood pressure
 
Blood pressure control
 
24‐h urinary excretion
 
1. Change in DBP
2. Change in SBP
3. Hypertension
4. 24‐h urinary sodium excretion
5. 24‐h urinary potassium excretion
1. 30 months
2. 30 months
3. 30 months
4. 30 months
5. 30 months
 
 
 
Kawasaki 1998 Individually randomised Japan Unclear 10.1% K LSSS (with 22.9 % Na; 1.2% Mg) 
 
Discretionary and non‐discretionary use (soy sauce, miso)
 
Participants to refrain from dining out and were not to change their lifestyle during the study period.
Regular salt
 
 
 
Discretionary and non‐discretionary use (regular soy sauce, miso)
 
Participants to refrain from dining out and were not to change their lifestyle during the study period.
21/20
 
65.9 (7.4)/65.8 (7.6) years
Female, %: 47.6/ 50
 
Hypertensive, %: 47.6/40.0
 
Antihypertensive medication use, %: 19.0/20.0
 
22.9 (2.7)/23.3 (2.3)  kg/m2
Change in blood pressure
 
Change in blood potassium
 
Change in blood lipids
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3. Change in blood potassium
4. Change in blood triglycerides
5. Change in total blood cholesterol
6. 24‐h urinary sodium excretion
7. 24‐h urinary potassium excretion
1. See Table 7
2. See Table 7
3. 5 weeks
4. 5 weeks
5. 5 weeks
6. 5 weeks
7. 5 weeks
Li 2016 Cluster‐randomised (villages) China Unclear 20.0% KCl (up to 35.0%) (with 70.0% ± 10.0% NaCl, iodine)
 
Discretionary use
 
LSSS for purchase at village shops (subsidised LSSS or non‐subsidised LSSS)
 
Community‐based health education programme on salt reduction 
 
50% of villages included in a concurrent trial (primary‐care‐based high cardiovascular risk management package delivered by village doctors)
Regular salt
 
 
 
 
Discretionary use
 
Regular salt for purchase at village shops
 
 
 
 
 
 
 
 
50% of villages included in a concurrent trial (primary‐care‐based high cardiovascular risk management package delivered by village doctors)
1268/1253/1272
 
Age NR
 
Gender NR
 
Hypertensive status NR
 
NR
 
NR
Change in blood pressure
 
Blood pressure control
 
Cardiovascular events
 
Hyperkalaemia
 
Change in BMI
 
Renal function
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3. Hypertension
4. Antihypertensive medication use
5. Various other cardiovascular events
6. Hyperkalaemia
7. Change in BMI
8. Microalbuminuria
9. Macroalbuminuria
10. Change in uACR
11. 24‐h urinary sodium excretion
12. 24‐h urinary potassium excretion
1. 18 months
2. 18 months
3. 18 months
4. 18 months
5. See Table 7
6. See Table 7
7. 18 months
8. 18 months
9. 18 months
10. 18 months
11. 18 months
12. 18 months
Mu 2009 Cluster‐randomised (families) China Unclear Unknown KCl LSSS
 
Discretionary use 
 
Provided for household use (quantity NR)
 
Co‐interventions NR
Regular salt
 
Discretionary use 
 
Provided for household use (quantity NR)
 
Co‐interventions NR
 
101/114
 
20.3 (3.1)/21.4 (3.9) years
 
Female, %: 55.5/47.4
 
Hypertensive
NR
 
23.6 (2.0)/23.8 (2.1)  kg/m2
Change in blood pressure
 
Hyperkalaemia
 
Adverse events
 
1. Change in DBP
2. Change in SBP
3. Hyperkalaemia
4. Various other adverse events
 
1. See Table 7
2. See Table 7
3. 2 years
4. > 12 months
 
Omvik 1995 Individually randomised Norway Unclear KCl 28% LSSS (with NaCl 57%; MgSO4 12%; lysine 2%).
 
Discretionary use
 
500 g provided for household use (frequency NR)
 
Participants instructed re. salt‐restricted diet
Regular salt
 
 
 
 
Discretionary use
 
500 g provided for household use (frequency NR)
 
Participants instructed re.salt‐restricted diet
20/20
 
45.9/42.7 years
 
Female, %: 30/35
 
Hypertensive
 
None
 
NR
Change in blood pressure
 
Cardiovascular events
 
Change in blood potassium
 
Renal function
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3.  Various other cardiovascular events
4. Change in blood potassium
5. Change in serum creatinine
6. 24‐h urinary sodium excretion
7. 24‐h urinary potassium excretion
1. 6 months
2. 6 months
3. > 3 to 12 months
4. 6 months
5. 6 months
6. 6 months
7. 6 months
 
Pereira 2005 Individually randomised Brazil Unclear 50% KCl LSSS (with 50% NaCl)
Discretionary use
1 kg provided for household use
Individualised hypocaloric diet and increased physical activity
Regular salt
 
 
Discretionary use 
 
 
1 kg provided for household use 
 
Individualised hypocaloric diet and increased physical activity
15/13
 
45.4 (13.2)/ 
 
Gender NR
 
Hypertensive
 
All participants on thiazide diuretics
 
32.5 (13.2)/30.2 (2.7) kg/m2
Change in blood pressure
 
Change in blood potassium
 
Hypokalaemia
 
Change in BMI
 
Renal function
 
Change in blood lipids
 
 
 
1. Change in DBP
2. Change in SBP
3. Change in blood potassium
4. Hypokalaemia
5. Change in BMI
6. Change in serum creatinine
7. Change in blood triglycerides
8. Change in total blood cholesterol
1. 12 weeks
2. 12 weeks
3. 12 weeks
4. 12 weeks
5. 12 weeks
6. 12 weeks
7. 12 weeks
8. 12 weeks
Sarkkinen 2011 Individually randomised Finland Unclear 25% KCl LSSS (with 
50% NaCl; 25% Mg) 
 
Discretionary use (quantity provided NR)
 
Non‐discretionary use (processed main dishes, bread, sausage/cold cuts and Edam cheese; to replace 60% of usual sodium intake)
 
Participants instructed to avoid salt‐rich products, products containing bioactive peptides, licorice, ammonium chloride products and any food supplements that may affect BP
Regular salt
 
 
Discretionary use
 
 
 
Non‐discretionary use (processed main dishes, bread, sausage/cold cuts and Edam cheese with regular salt content)
Participants instructed to avoid salt‐rich products, products containing bioactive peptides, licorice, ammonium chloride products and any food supplements that may affect BP
22/23
 
57 (12)/54 (11) years
 
Female, %: 59/39
 
Hypertensive
 
None
 
28 (3)/28 (3) kg/m2
Change in blood pressure
 
Cardiovascular events
 
Adverse events
 
Change in blood potassium
 
Change in BMI
 
24‐h urinary excretion
 
 
 
1. Change in DBP
2. Change in SBP
3.  Various other cardiovascular events
4. Various other adverse events
5. Change in blood potassium
6. Change in BMI
7. 24‐h urinary sodium excretion
8. 24‐h urinary potassium excretion
1. 8 weeks
2. 8 weeks
3. ≤ 3 months
4. ≤ 3 months
5. See Table 7
6. 8 weeks
7. 8 weeks
8. 8 weeks
Suppa 1988 Individually randomised Italy Unclear KCl 25% (with 50% NaCl and 15% K3C6H5O7)
 
Discretionary use 
 
2 g provided twice daily 
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use 
 
2 g provided twice daily
 
Co‐interventions NR
163/159
 
47.1 (9.8)/47.8 (10.1) years
 
Female, %: 35.6/39
 
Hypertensive
 
All participants on  β‐blocker monotherapy (Metoprolol)
 
NR
Change in blood pressure
 
Cardiovascular events
 
Adverse events
 
24‐h urinary excretion
 
 
 
1. Change in DBP
2. Change in SBP
3. Various other cardiovascular events
4. Various other adverse events
5. 24‐h urinary sodium excretion
6. 24‐h urinary potassium excretion
1. 4 weeks
2. 4 weeks
3. See Table 7
4. See Table 7
5. 4 weeks
6. 4 weeks
 
 
 
 
 
 
 
 
 
Toft 2020 Cluster‐randomised (families) Denmark Unclear < 30% KCl LSSS (Per 100g: approximately 8000 mg sodium; 870 mg Mg and 100 mg‐200 mg K estimated from the technical data sheet)
 
Non‐discretionary use (LSSS bread products to replace usual consumption), provided to families twice a week
 
Co‐interventions NR
Regular salt
 
 
 
 
 
Non‐discretionary use (regular wholegrain bread products for usual consumption), provided to families twice a week
 
 
Co‐interventions NR
81/101
 
41.5 (9.5)/ 40.9 (8.0) years
 
Female, %: 47.5/53.1
 
Normotensive
 
N/A
 
25.8 (3.8)/24.8 (4.1) 
kg/m2
Change in blood pressure
 
Change in BMI
 
Change in blood glucose
 
Change in blood lipids
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3. Change in BMI
4. Change in fasting blood glucose
 
 
5. Change in blood triglycerides
6. Change in total blood cholesterol
7. 24‐h urinary sodium excretion
8. 24‐h urinary potassium excretion
1. 4 months
2. 4 months
3. 4 months
4. 4 months
5. 4 months
6. 4 months
7. 4 months
8. 4 months
 
 
 
 
Zhou 2013 Cluster‐randomised (families) China Unclear 25% KCl LSSS (with 65% NaCl, 10% MgSO4). 
 
Discretionary use
 
Estimated amount (based upon baseline salt intake) provided every 3 months for household use
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use 
 
Estimated amount (based upon baseline salt intake) provided every 3 months for household use
 
 
Co‐interventions NR
224/238
 
45.63 (13.72)/ 47.05 (13.46) years
 
Female, %: 50.45/50.84
 
NR
 
Any antihypertensive use, %: 41.07/40.0
 
25.94 (3.82)/26.66 (4.27) kg/m2
 
Change in blood pressure
 
Mortality
 
Blood pressure control
 
 
 
 
 
 
 
 
 
 
 
1. Change in DBP
2. Change in SBP
3. Cardiovascular mortality
4. Stroke mortality
5. All‐cause mortality
6. Antihypertensive medication use
1. 36 months
2. 36 months
3. 13 years
4. 13 years
5. 13 years
6. 36 months
 
 
 
 
Chang 2006 Cluster‐randomised (Retirement home kitchens) Taiwan High 49% KCl LSSS (with 49% NaCl, 2% other additives)
 
Discretionary use
LSSS gradually replaced regular salt in the kitchens within a 4‐week period. Frequency and quantity provided NR
 
Regular condiments and spices e.g. soy sauce and MSG, not limited
Regular salt
 
 
 
 
Discretionary use 
 
 
Frequency and
quantity provided NR
 
 
 
 
Regular condiments and spices e.g. soy sauce and MSG, not limited
768/1213
 
75.21 (7.37)/74.67 years
 
Male
 
Hypertensive, % (n/N): 40.2/40.4
 
NR
 
23.3 (3.5) kg/m2
 
Mortality
 
 
 
 
 
 
 
 
 
 
 
1. Cardiovascular mortality
2. All‐cause mortality
 
1. 2.6 years mean follow‐up
2. 2.6 years mean follow‐up
 
 
 
Geleijnse 1994 Individually randomised Netherlands High 41% KCl LSSS (with 41% NaCl, 17% Mg) 
 
Discretionary use
 
Non‐discretionary use (use of LSSS in bread, cheese, luncheon meats, canned and instant soups, smoked sausage ‐ replacement of approx. 57% of usual salt intake) 
 
Quantity provided and frequency NR 
 
Participants were instructed not to change dietary and lifestyle habits.
Regular salt
 
 
 
Discretionary use 
 
Non‐discretionary use (use of regular bread, cheese, luncheon meats, canned and instant soups, smoked sausage)
 
 
 
Quantity provided and frequency NR 
 
Participants were instructed not to change dietary and lifestyle habits.
49/51
 
65.7 (4.6)/ 67.1 (4.5) years
 
 
Female, %: 47/51
 
Hypertensive
 
None
 
27.1 (3.4)/27.2 (3.2) kg/m2
Change in blood pressure
 
Change in blood potassium
 
Change in blood lipids
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3. Change in blood potassium
4. Change in total blood cholesterol
5. 24‐h urinary sodium excretion
6. 24‐h urinary potassium excretion
1. 24 weeks
2. 24 weeks
3. 24 weeks
4. 24 weeks
5. 24 weeks
6. 24 weeks
 
 
 
Gilleran 1996 Individually randomised United Kingdom High 40% KCl LSSS (with 50% NaCl and 10% MgSO4). 
 
Discretionary use
 
680 g provided monthly for household use
 
Co‐interventions NR
Regular salt
 
 
 
Discretionary use
 
680 g provided monthly for household use
 
Co‐interventions NR
20/20
 
62.5 (7.8)/ 59.2 (10.8) years
 
Female, %: 40/40
 
Hypertensive
 
None
 
28.1 (4.6)/28.6 (3.7) kg/m2
Change in blood pressure
 
Cardiovascular events
 
Change in blood lipids
 
24‐h urinary excretion
 
 
1. Change in DBP
2. Change in SBP
3. Cardiovascular events: non‐fatal stroke
4. Change in blood triglycerides
5. Change in total blood cholesterol
6. 24‐h urinary sodium excretion
7. 24‐h urinary potassium excretion
1. 9 months
2. 9 months
3. ≤ 3 months
4. 9 months
5. 9 months
6. 9 months
7. 9 months
 
 
 
 
 
 
 
 
 
Hu 2018 Cluster‐randomised (families) China High 25% KCl LSSS (with 65% NaCl, 10% MgSO4). 
 
Discretionary use
1 kg bags provided for household use (frequency NR)
 
Participants instructed to avoid any changes in dietary or lifestyle habits.
 
Regular salt
 
 
 
Discretionary use
 
1 kg bags provided for household use (frequency NR) 
 
Participants instructed to avoid any changes in dietary or lifestyle habits.
110/110
 
57.1 (10.9)/ 57.6 (10.1) years
 
Female, %: 33.6/60.0
 
Hypertensive
 
Antihypertensive medication use, %: 71.8/77.3
 
27.6 (3.3)/28.3 (3.5) kg/m2
 
187/186 family members
 
45.5 (17.5)/45.7 (17.4) years 
 
Female, %: 45.5/47.4
 
Hypertensive, % (n/N): 31.6/24.2
 
None
 
24.9 (3.8)/25.2 (4.3) 
kg/m2
Change in blood pressure
 
Adverse events
 
Blood pressure control
 
 
1. Change in DBP
2. Change in SBP
3. Various other adverse events
4. Antihypertensive medication use
1. 12 months
2. 12 months
3. > 3 to 12 months
4. 12 months
 
 
 
 
 
Mu 2003 Individually randomised China High Unknown KCl LSSS
 
Discretionary use 
 
Provided for household use monthly (quantity NR)
 
Co‐interventions: None
 
Regular salt
 
Discretionary use 
 
Provided for household use monthly (quantity NR)
 
Co‐interventions: None
 
110/110
 
20.7(2.0)/20.4 (2.2) years
 
Female; %: 47.3/49
 
Hypertensive
 
NR
 
21.9 (2.9)/22.2 (3.1) kg/m2
Change in blood pressure
 
 
 
 
1. Change in DBP
2. Change in SBP
 
 
1. 2 years
2. 2 years
 
 
 
 
 
Zhang 2015 Cluster‐randomised (nursing homes) China High 50% KCl (with 50% NaCl)
 
Discretionary use of up to 10 g per person per day
 
LSSS provided every 3 months
Co‐interventions NR
Regular salt
 
 
Discretionary use of up to 10 g per person per day
 
Regular salt provided every 3 months
Co‐interventions NR
NR
 
65 years
 
Gender NR
 
NR
 
NR
 
NR
Change in blood pressure
 
Change in blood potassium
 
Hyperkalaemia
 
Renal function
 
1. Change in DBP
2. Change in SBP
3. Change in blood potassium
4. Hyperkalaemia
5. Change in serum creatinine
6. Microalbuminuria
1. 3 years
2. 3 years
3. 1 to 1.5 years
4. 1 to 1.5 years
5. 1 to 1.5 years
6. 3 years
 

Abbreviations: 
24‐h: 24‐hour
BMI: body mass index
BP: blood pressure
DBP: diastolic blood pressure
K3C6H507: potassium citrate
K(Cl): potassium (chloride)
LSSS: low‐sodium salt substitutes
Mg(SO4): magnesium (sulphate)
MSG: monosodium glutamate
N/A: not applicable
Na(Cl): sodium (chloride)
NR: not reported
SBP: systolic blood pressure
uACR: urinary albumin‐to‐creatinine ratio