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Reply to CK Chow

Center for Health Policy Research and Development
National Health Research Institutes
Zhunan
Maoli, 350
Taiwan
E-mail: hsingyi{at}nhri.org.tw

Wen-Harn Pan

Institute of Biomedical Sciences
Academia Sinica
Nan-Kong
Taipei, 115
Taiwan

Dear Sir:

In our article entitled "Effects of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men" (1), we reported the beneficial effects of potassium-enriched salt on the survival and medical cost with regard to cardiovascular diseases (CVDs). We did not conclude that "the beneficial effects on the cardiovascular survivorship observed was attributed solely to potassium-enrichment" as Chow perceived. Instead, we stated fairly, "The effect was likely due to a major increase in potassium and a moderate reduction in sodium intake" (the last sentence of the abstract) and "The present study showed a long-term effect on CVD mortality and medical expenditure associated with lowering the sodium-to-potassium ratio" (the first sentence of the discussion).

Our statements are well-grounded, because the urine electrolyte data showed a moderate decrease in the sodium-to-creatinine ratio [ (±SD): 1.34 ± 0.92 to 1.22 ± 0.73] and a sharp increase in potassium-to-creatinine ratio (0.28 ± 0.14 to 0.48 ± 0.23) in the experimental group. On the other hand, there was a slight increase in sodium-to-creatinine ratio (1.14 ± 0.74 to 1.23 ± 0.76) and almost no change in potassium-to-creatinine ratio (0.28 ± 0.14 to 0.27 ± 0.12) in the control group.

The key point of our article is that we successfully adopted an easy-to-implement food base–like approach based on the rationale that "the use of potassium-enriched salt has the combined advantages of reducing sodium and increasing potassium" and that this approach can be taken without giving up the salty taste completely. Some people find the taste of potassium chloride salt unacceptable and refuse to use it. The idea of using a partially potassium-enriched salt was to compromise between a predilection for the taste of salt and a need for a salt substitute with a low sodium-to-potassium ratio. We believe that by increasing the intake of fruit and vegetables and by using potassium-enriched salt with the highest endurable potassium content, one can maximize the benefit for blood pressure control and cardiovascular disease protection.

ACKNOWLEDGMENTS

The authors had no conflict of interest.

REFERENCE

1. Chang H-Y, Hu Y-W, Yue C-SJ, et al. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men. Am J Clin Nutr 2006;83:1289–96.[Abstract/Free Full Text]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chang, H.-Y. Articles by Pan, W.-H. Search for Related Content PubMed Articles by Chang, H.-Y. Articles by Pan, W.-H. Agricola Articles by Chang, H.-Y. Articles by Pan, W.-H.