Global Sodium Consumption and Death from Cardiovascular Causes
Global Sodium Consumption and Death from Cardiovascular Causes
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DOI：
10.1056/nejmoa1304127
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发表时间：
2014-08-14
影响因子：
158.5
通讯作者：
Powles, John
中科院分区：
文献类型：
--
作者：
Mozaffarian, Dariush;Fahimi, Saman;Powles, John
高钠摄入会增加血压，这是心血管疾病的一个危险因素，但钠摄入对全球心血管死亡率的影响尚不确定。（占全球成年人的74.1%），我们使用这些数据根据年龄，性别和国家量化全球钠消费量。钠对血压的影响，根据年龄，种族和高血压的存在或不存在，是根据一项新的荟萃分析的107个随机干预措施的数据计算的，血压对心血管死亡率的影响，根据年龄，从队列荟萃分析计算。死因别死亡率来自2010年全球疾病负担研究。使用比较风险评估，我们估计目前的钠摄入量的心血管影响，相比，每天2.0克的钠的参考摄入量，根据年龄，性别和国家。2010年，全球钠消费量的估计平均水平为3.95克每天，区域平均水平范围为2.18至5.51克每天。在全球范围内，每年有165万人死于心血管疾病（95%不确定性区间[置信区间]，110万至222万），归因于钠摄入量高于参考水平;这些死亡中61.9%发生在男性，38.1%发生在女性。这些死亡占心血管原因死亡的近十分之一（9.5%）。每5例死亡中有4例（84.3%）发生在低收入和中等收入国家，每5例死亡中有2例（40.4%）是过早死亡（70岁之前）。与钠摄入量高于参考水平的心血管原因的死亡率是最高的国家的格鲁吉亚和最低的Keny.CONCLUSIONSIn本建模研究，165万人死于心血管原因，发生在2010年归因于钠消费量高于参考水平的2.0克，每天。
BACKGROUNDHigh sodium intake increases blood pressure, a risk factor for cardiovascular disease, but the effects of sodium intake on global cardiovascular mortality are uncertain.METHODSWe collected data from surveys on sodium intake as determined by urinary excretion and diet in persons from 66 countries (accounting for 74.1% of adults throughout the world), and we used these data to quantify the global consumption of sodium according to age, sex, and country. The effects of sodium on blood pressure, according to age, race, and the presence or absence of hypertension, were calculated from data in a new meta-analysis of 107 randomized interventions, and the effects of blood pressure on cardiovascular mortality, according to age, were calculated from a meta-analysis of cohorts. Cause-specific mortality was derived from the Global Burden of Disease Study 2010. Using comparative risk assessment, we estimated the cardiovascular effects of current sodium intake, as compared with a reference intake of 2.0 g of sodium per day, according to age, sex, and country.RESULTSIn 2010, the estimated mean level of global sodium consumption was 3.95 g per day, and regional mean levels ranged from 2.18 to 5.51 g per day. Globally, 1.65 million annual deaths from cardiovascular causes (95% uncertainty interval [confidence interval], 1.10 million to 2.22 million) were attributed to sodium intake above the reference level; 61.9% of these deaths occurred in men and 38.1% occurred in women. These deaths accounted for nearly 1 of every 10 deaths from cardiovascular causes (9.5%). Four of every 5 deaths (84.3%) occurred in low-and middle-income countries, and 2 of every 5 deaths (40.4%) were premature (before 70 years of age). The rate of death from cardiovascular causes associated with sodium intake above the reference level was highest in the country of Georgia and lowest in Kenya.CONCLUSIONSIn this modeling study, 1.65 million deaths from cardiovascular causes that occurred in 2010 were attributed to sodium consumption above a reference level of 2.0 g per day.