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New Study: Low-Sodium Salt Can Save from Heart Attacks


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Heart attacks, often resulting from high blood pressure, remain a leading cause of death globally. Recent studies shed light on effective strategies to combat this silent killer. Notably, the prevalence of high blood pressure is rising in countries like Indonesia, posing significant public health challenges. This article delves into the latest findings on heart attack prevention, emphasizing the critical role of diet, particularly sodium and potassium intake, and innovative health policies.

The Silent Killer: High Blood Pressure

High blood pressure, or hypertension, is aptly termed a “silent killer” because its symptoms often go unnoticed until severe complications, such as stroke or heart attack, arise. In Indonesia, the situation is alarming, with the prevalence of high blood pressure increasing rapidly.

Rising Prevalence in Indonesia

As of 2018, one in three Indonesians aged 18 and above and up to half of those over 40 have high blood pressure, a significant rise from one in four affected adults just five years earlier. This surge is largely attributed to unhealthy diets, particularly those high in sodium and low in potassium.

Sodium and Potassium: A Delicate Balance

The World Health Organization (WHO) recommends a maximum daily sodium intake of 2000 mg (about one teaspoon of salt) and at least 3510 mg of potassium. However, a national survey in Indonesia revealed that more than half of the population exceeds the recommended sodium intake, while practically no one meets the potassium intake guidelines. This imbalance significantly increases the risk of high blood pressure and related health issues.

Innovative Solutions: Salt Substitutes

Recent research highlights salt substitutes as an effective strategy to address high blood pressure. These substitutes, which reduce sodium content and increase potassium, offer a practical and affordable solution.

Findings from Indonesia

A study published in The Lancet Regional Health – Southeast Asia estimated the benefits of switching from regular salt to low-sodium potassium-enriched salt substitutes. Using a simulation model, researchers projected the long-term impacts of a government-led policy promoting these substitutes, primarily for home cooking and seasoning.

Projected Health Benefits

The model predicted significant health benefits over a ten-year period:

  • Prevention of Non-Fatal Cases: Over 1.5 million non-fatal cases of heart attack and stroke could be prevented.
  • Reduction in Chronic Kidney Disease: 643,000 new cases of chronic kidney disease could be averted.
  • Lives Saved: More than 200,000 deaths from heart disease, stroke, and chronic kidney disease could be postponed or prevented.

Economic Implications

Implementing the salt substitute policy would cost approximately US$ 2.1 billion (about IDR 29.7 trillion) over 20 years. However, the savings from reduced health expenditure, estimated at US$ 7.3 billion (about IDR 103.2 trillion), far outweigh the costs, making this a cost-effective strategy.

Global Perspective

Similar studies in countries like China, India, Cameroon, Vietnam, and New Zealand have reported substantial health gains and cost savings from the use of salt substitutes. This underscores the global applicability of this approach in managing high blood pressure and its consequences.

Policy Recommendations

To combat the rising tide of noncommunicable diseases, the WHO has called for a 30% reduction in salt intake globally, a policy endorsed by the Indonesian Ministry of Health. However, cultural preferences for salty flavors in local cuisine pose a significant challenge.

Practical Steps

For countries like Indonesia, where most dietary sodium comes from added salt during cooking, replacing regular salt with low-sodium alternatives can help people reduce their sodium intake without compromising taste. These substitutes resemble regular salt in appearance and taste, enhancing their acceptability.

Broader Health Impact

Reducing sodium intake through salt substitutes can significantly decrease the incidence of heart attacks, strokes, and kidney disease, easing the burden on healthcare systems and yielding substantial savings in health expenditure.

Critical role of diet

The latest research underscores the critical role of diet in preventing heart attacks and managing high blood pressure. Salt substitutes, which lower sodium and increase potassium intake, offer a promising solution to this global health challenge. For countries like Indonesia, adopting policies to promote these substitutes can lead to significant health improvements and economic benefits. By addressing dietary habits and implementing innovative health policies, we can make substantial strides in reducing the prevalence of heart attacks and enhancing public health worldwide.

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