Projected effect of dietary salt reductions on future cardiovascular disease.
Projected effect of dietary salt reductions on future cardiovascular disease.
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DOI：
10.1056/nejmoa0907355
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发表时间：
2010-02-18
期刊：
影响因子：
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通讯作者：
Goldman L
中科院分区：
文献类型：
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作者：
Bibbins-Domingo K;Chertow GM;Coxson PG;Moran A;Lightwood JM;Pletcher MJ;Goldman L
美国饮食中的盐含量很高，大部分来自加工食品。减少膳食盐是一个重要的潜在公共卫生目标。我们使用冠状动脉心脏病（CHD）政策模型来量化可能实现的全民饮食盐减少高达3 gm/天（1200 mg/天的钠）的益处。我们估计了年龄、性别和种族亚组的心血管疾病发病率和成本，将减盐与其他降低心血管风险的干预措施进行了比较，并确定了减盐与药物治疗高血压相比的成本效益。每天减少3克盐预计将导致每年减少60，000 - 120，000例新的CHD病例，减少32，000 - 66，000例新的中风，减少54，000 - 99，000例心肌梗死，减少44，000 - 92，000例任何原因的死亡。所有人群都将受益，黑人受益比例更大，女性受益尤其是中风减少，老年人受益于CHD事件减少，年轻人受益于死亡率降低。低盐对心血管的益处与减少烟草、肥胖或胆固醇的益处相当。旨在实现每天减少3克盐的监管干预措施将每年节省194，000 - 392，000个质量调整生命年和100 - 240亿美元的医疗保健费用。即使在2010-2019年的十年中仅逐渐减少1克/天，这种干预也会节省成本，并且比用药物治疗所有高血压患者更具成本效益。适度减少饮食中的盐可以大大减少心血管事件和医疗费用，应该成为公共卫生目标。
The US diet is high in salt, with the majority coming from processed foods. Reducing dietary salt is an important potential public health target. 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 gm/day (1200 mg/day of sodium). We estimated cardiovascular disease rates and costs in age, sex, and race subgroups, compared salt reduction with other interventions to reduce cardiovascular risk, and determined the cost-effectiveness of salt reduction compared with drug treatment of hypertension. Reducing salt by 3 gm/day is projected to result in 60,000–120,000 fewer new CHD cases, 32,000–66,000 fewer new strokes, 54,000–99,000 fewer myocardial infarctions, and 44,000–92,000 fewer deaths from any cause annually. 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 from lower salt are on par with benefits from reducing tobacco, obesity, or cholesterol. A regulatory intervention designed to achieve 3 gm/day salt reduction would save 194,000–392,000 quality-adjusted life-years and $10–24 billion in healthcare costs annually. Such an intervention would be cost-saving even if only a modest 1 gm/day reduction were achieved gradually over the decade from 2010–2019 and would be more cost-effective than treating all hypertensive individuals with medications. Modest reduction in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target.