Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches.

Pubmed ID: 23399718

Journal: Hypertension (Dallas, Tex. : 1979)

Publication Date: March 1, 2013

MeSH Terms: Humans, Male, Adult, Female, Models, Biological, Aged, Aged, 80 and over, Cardiovascular Diseases, United States, Middle Aged, Hypertension, Randomized Controlled Trials as Topic, Computer Simulation, Forecasting, Mortality, Epidemiologic Studies, Antihypertensive Agents, Sodium, Dietary

Authors: Bibbins-Domingo K, Coxson PG, Hong Y, Cook NR, Joffres M, Orenstein D, Schmidt SM

Cite As: Coxson PG, Cook NR, Joffres M, Hong Y, Orenstein D, Schmidt SM, Bibbins-Domingo K. Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches. Hypertension 2013 Mar;61(3):564-70. Epub 2013 Feb 11.

Studies:

Abstract

Computer simulations have been used to estimate the mortality benefits from population-wide reductions in dietary sodium, although comparisons of these estimates have not been rigorously evaluated. We used 3 different approaches to model the effect of sodium reduction in the US population over the next 10 years, incorporating evidence for direct effects on cardiovascular disease mortality (method 1), indirect effects mediated by blood pressure changes as observed in randomized controlled trials of antihypertension medications (method 2), or epidemiological studies (method 3).The 3 different modeling approaches were used to model the same scenarios: scenario A, gradual uniform reduction totaling 40% over 10 years; scenario B, instantaneous 40% reduction in sodium consumption sustained for 10 years to achieve a population-wide mean of 2200 mg/d; and scenario C, instantaneous reduction to 1500 mg sodium per day sustained for 10 years. All 3 methods consistently show a substantial health benefit for reductions in dietary sodium under each of the 3 scenarios tested. A gradual reduction in dietary sodium over the next decade (scenario A) as might be achieved with a range of proposed public health interventions would yield considerable health benefits over the next decade, with mean effects across the 3 models ranging from 280 000 to 500 000 deaths averted. Projections of instantaneous reductions illustrate the maximum benefits that could be achieved (0.7-1.2 million deaths averted in 10 years). Under 3 different modeling assumptions, the projected health benefits from reductions in dietary sodium are substantial.