02-009 · EVIDENCE A · SOURCE-SENSITIVE
Switch household salt to low‑sodium (potassium‑rich) salt
把家里的食盐换成低钠盐（钾盐）
One bag costs a few yuan more than regular salt. It’s easy to switch when you shop, adding virtually no extra time. The taste stays almost the same.
For people who have had a stroke or are over 60 with hypertension, switching to low‑sodium salt can lower their chance of dying within five years by about 12% and the risk of another stroke by roughly 14%.
A
Move “Switch household salt to low‑sodium (potassium‑rich) salt” to Future Me's calendar
The excuse
The routine already works until the day the source says it may not.
What feels good now
Today I keep a little money, a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “For people who have had a stroke or are over 60 with hypertension, switching to low‑sodium salt can lower their chance of dying within five years by about 12% and the risk of another stroke by roughly 14%.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
9. Switch household salt to low‑sodium (potassium‑rich) salt
Cost: One bag costs a few yuan more than regular salt. It’s easy to switch when you shop, adding virtually no extra time. The taste stays almost the same.
In plain terms: For people who have had a stroke or are over 60 with hypertension, switching to low‑sodium salt can lower their chance of dying within five years by about 12% and the risk of another stroke by roughly 14%.
Benefit: A randomized trial conducted in rural China enrolled 20,995 participants — all stroke survivors or adults aged 60+ with hypertension — and followed them for 4.74 years. Those using low‑sodium salt had a 12% lower risk of death (RR 0.88), a 14% lower risk of stroke (RR 0.86), and a 13% lower risk of major cardiovascular events (RR 0.87) compared with the regular‑salt group. No statistically significant difference emerged between the groups regarding episodes of excessively high blood potassium levels.
Evidence grade: A
Sources: Neal B et al. (2021). Effect of Salt Substitution on Cardiovascular Events and Death. NEJM. <https://doi.org/10.1056/NEJMoa2105675>; O'Donnell M et al. (2014). Urinary sodium and potassium excretion, mortality, and cardiovascular events. NEJM. <https://doi.org/10.1056/NEJMoa1311889> (disputing party PURE)
Notes: This finding is somewhat controversial. The PURE study only recorded long‑term outcomes without random assignment; it reported that individuals excreting less than 3 g of sodium per day faced a roughly 27% higher risk of death or cardiovascular events, while those excreting more than 7 g per day faced a 15% higher risk. According to PURE, both very low and very high sodium intake are detrimental, with moderate intake being optimal. However, the Chinese rural trial only partially replaced regular salt with low‑sodium salt, so sodium levels did not drop to the extremes examined in PURE. Moreover, the trial involved only high‑risk elderly participants; younger, healthier individuals would likely gain far less benefit. People with impaired kidney function or those taking potassium‑sparing medications should consult a physician before making this switch.
Read the complete Chinese source and notes
9. 把家里的食盐换成低钠盐（钾盐）
成本: 一袋比普通盐贵几元。买的时候顺手换，不额外占时间。口味几乎不变。
说人话: 得过中风或 60 岁以上有高血压的人，把家里的盐换成低钠盐，五年内死亡的概率低约 12%，中风低约 14%。
收益: 一项把人随机分成两组的试验，在中国农村做的，20995 人，都是得过卒中的人或者 60 岁以上的高血压病人，跟踪了 4.74 年。结果：用低钠盐的那组比用普通盐的那组，死亡风险低约 12%（RR 0.88）。卒中低约 14%（RR 0.86）。主要心血管事件低约 13%（RR 0.87）。血钾过高的事件，两组没看出统计上的差别。
证据等级: A
来源: Neal B 等 (2021). Effect of Salt Substitution on Cardiovascular Events and Death. NEJM. <https://doi.org/10.1056/NEJMoa2105675>；O'Donnell M 等 (2014). Urinary sodium and potassium excretion, mortality, and cardiovascular events. NEJM. <https://doi.org/10.1056/NEJMoa1311889>（争议方 PURE）
备注: 争议。PURE 这项研究只长期跟踪记录，不分组。它报告：一天排钠不到 3 g 的人，死亡加心血管事件的风险高约 27%。一天排钠 7 g 以上的人，高约 15%。按它的结果，吃太少和吃太多都不好，中间最好。但本条引的那项中国农村随机试验里，低钠盐只是替换掉一部分，不会把钠压得那么低。另外要注意，试验对象是高危老人。健康年轻人换盐得到的好处要小得多。肾功能不全的人，或者正在吃保钾类药物的人，换盐前先问医生。
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