Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men

Background: The beneficial effects of potassium-enriched salt on blood pressure have been reported in a few short-term trials. The long-term effects of potassium-enriched salt on cardiovascular mortality have not been carefully studied. Objective: The objective was to examine the effects of potassium-enriched salt on cardiovascular disease (CVD) mortality and medical expenditures in elderly veterans. Design: Five kitchens of a veteran retirement home were randomized into 2 groups (experimental or control) and veterans assigned to those kitchens were given either potassium-enriched salt (experimental group) or regular salt (control group) for ≈31 mo. Information on death, health insurance claims, and dates that veterans moved in or out of the home was gathered. Results: Altogether, 1981 veterans, 768 in the experimental [x^- (±SD) age: 74.8 ± 7.1 y] and 1213 in the control (age: 74.9 ± 6.7 y) groups, were included in the analysis. The experimental group had better CVD survivorship than did the control group. The incidence of CVD-related deaths was 13.1 per 1000 persons (27 deaths in 2057 person-years) and 20.5 per 1000 (66 deaths in 3218 person-years) for the experimental and control groups, respectively. A significant reduction in CVD mortality (age-adjusted hazard ratio: 0.59; 95% CI: 0.37, 0.95) was observed in the experimental group. Persons in the experimental group lived 0.3-0.90 y longer and spent significantly less (≈US $426/y) in inpatient care for CVD than did the control group, after control for age and previous hospitalization expenditures. Conclusions: This study showed a long-term beneficial effect on CVD mortality and medical expenditure associated with a switch from regular salt to potassium-enriched salt in a group of elderly veterans. The effect was likely due to a major increase in potassium and a moderate reduction in sodium intakes.