by Jonathan Galland

 

Hold the salt

A recent study published in The New England Journal of Medicine projects big benefits to public health that could occur with a small reduction in daily salt intake.

 

The authors of the study estimate that cutting back on just 3 grams of salt a day per person, could bring a dramatic decrease in serious illness from coronary heart disease (CHD).

 

Cutting back salt intake by about half a teaspoon a day could reduce:

 

 

The research was conducted by scientists from the University of California, San Francisco (UCSF); Stanford University, and Columbia University, New York.

 

The scientists note the significant advantages of reducing salt intake: “All segments of the population would  benefit, with blacks benefiting proportionately more, women benefiting particularly from stroke reduction, older adults from reductions in CHD events, and younger adults from lower mortality rates.” (Kirsten Bibbins-Domingo, PhD, MD,et al.)

 

Holding the salt could also save $10 billion to $24 billion in health care costs annually. This, the study concludes “would be more cost-effective than using medications to lower blood pressure in all persons with hypertension”. (Ibid.)   

 

Reference and Abstract:

 

N Engl J Med. 2010 Jan 20. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease.  Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, Goldman L.

 

From the Departments of Medicine (K.B.-D., P.G.C., M.J.P.), Epidemiology and Biostatistics (K.B.-D., M.J.P.), and Clinical Pharmacy, School of Pharmacy (J.M.L.), University of California, San Francisco (UCSF); and the Division of General Internal Medicine and the Center for Vulnerable Populations at San Francisco General Hospital, UCSF (K.B.-D., P.G.C.) – all in San Francisco; the Department of Medicine, Stanford University, Palo Alto, CA (G.M.C.); and the Department of Medicine, College of Physicians and Surgeons, Columbia University, New York (A.M., L.G.). This article (10.1056/NEJMoa0907355) was published on January 20, 2010, at NEJM.org.

 

BACKGROUND: The U.S. diet is high in salt, with the majority coming from processed foods. Reducing dietary salt is a potentially important target for the improvement of public health. METHODS: We used the Coronary Heart Disease (CHD) Policy Model to quantify the benefits of potentially achievable, population-wide reductions in dietary salt of up to 3 g per day (1200 mg of sodium per day). We estimated the rates and costs of cardiovascular disease in subgroups defined by age, sex, and race; compared the effects of salt reduction with those of other interventions intended to reduce the risk of cardiovascular disease; and determined the cost-effectiveness of salt reduction as compared with the treatment of hypertension with medications.

 

RESULTS: Reducing dietary salt by 3 g per day is projected to reduce the annual number of new cases of CHD by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 and to reduce the annual number of deaths from any cause by 44,000 to 92,000. All segments of the population would benefit, with blacks benefiting proportionately more, women benefiting particularly from stroke reduction, older adults from reductions in CHD events, and younger adults from lower mortality rates. The cardiovascular benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use, obesity, and cholesterol levels. A regulatory intervention designed to achieve a reduction in salt intake of 3 g per day would save 194,000 to 392,000 quality-adjusted life-years and $10 billion to $24 billion in health care costs annually. Such an intervention would be cost-saving even if only a modest reduction of 1 g per day were achieved gradually between 2010 and 2019 and would be more cost-effective than using medications to lower blood pressure in all persons with hypertension.

 

CONCLUSIONS: Modest reductions in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target.

 

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