Mortality Benefits From US Population-wide Reduction in Sodium Consumption Projections From 3 Modeling Approaches
Mortality Benefits From US Population-wide Reduction in Sodium Consumption Projections From 3 Modeling Approaches
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DOI：
10.1161/hypertensionaha.111.201293
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发表时间：
2013-03-01
期刊：
影响因子：
8.3
通讯作者：
Bibbins-Domingo, Kirsten
中科院分区：
文献类型：
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作者：
Coxson, Pamela G.;Cook, Nancy R.;Bibbins-Domingo, Kirsten
计算机模拟已被用于估计从人口范围内减少膳食钠的死亡率收益，尽管这些估计的比较尚未得到严格的评估。我们使用3种不同的方法来模拟未来10年美国人群中钠减少的影响，包括对心血管疾病死亡率的直接影响（方法1），降压药物随机对照试验中观察到的血压变化介导的间接影响（方法2）或流行病学研究（方法3）。使用3种不同的建模方法对相同的情景进行建模：情景A，在10年内逐步统一减少40%;情景B，持续10年瞬时减少40%的钠消耗量，以实现全人群平均2200 mg/d;情景C，持续10年瞬时减少至1500 mg/d。所有3种方法一致显示，在测试的3种情景下，减少膳食钠对健康有重大益处。通过一系列拟议的公共卫生干预措施，在未来十年内逐步减少膳食钠（情景A），将在未来十年内产生相当大的健康效益，3种模式的平均效应范围为280 000至500 000例死亡。对瞬时减少的预测表明了可以实现的最大效益（10年内避免70万至120万人死亡）。在3种不同的建模假设下，减少膳食钠的预计健康益处是巨大的。（高血压。2013;61：564-570）。circle在线数据补充
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. (Hypertension. 2013;61:564-570.) circle Online Data Supplement