Dietary Salt Reduction, Prevalence of Hypertension and Avoidable Burden of Stroke in Vietnam: Modelling the Health and Economic Impacts

Abstract

Dietary salt reduction has been recommended as a cost-effective population-wide strategy to prevent cardiovascular disease. The health and economic impact of salt consumption on the future burden of stroke in Vietnam is not known.Objective: To estimate the avoidable incidence of and deaths from stroke, as well as the healthy life years and healthcare costs that could be gained from reducing salt consumption in Vietnam.Methods: This was a macrosimulation health and economic impact assessment study. Data on blood pressure, salt consumption and stroke epidemiology were obtained from the Vietnam 2015 STEPS survey and the Global Burden of Disease study. A proportional multi-cohort multistate lifetable Markov model was used to estimate the impact of achieving the Vietnam national salt targets of 8 g/day by 2025 and 7 g/day by 2030, and to the 5 g/day WHO recommendation by 2030. Probabilistic sensitivity analysis was conducted to quantify the uncertainty in our projections.Results: If the 8 g/day, 7 g/day, and 5 g/day targets were achieved, the prevalence of hypertension could reduce by 1.2% (95% uncertainty interval [UI]: 0.5 to 2.3), 2.0% (95% UI: 0.8 to 3.6), and 3.5% (95% UI: 1.5 to 6.3), respectively. This would translate, respectively, to over 80,000, 180,000, and 257,000 incident strokes and over 18,000, 55,000, and 73,000 stroke deaths averted. By 2025, over 56,554 stroke-related health-adjusted life years (HALYs) could be gained while saving over US$ 42.6 million in stroke healthcare costs. By 2030, about 206,030 HALYs (for 7 g/day target) and 262,170 HALYs (for 5 g/day target) could be gained while saving over US$ 88.1 million and US$ 122.3 million in stroke healthcare costs respectively.Conclusion: Achieving the national salt reduction targets could result in substantial population health and economic benefits. Estimated gains were larger if the WHO salt targets were attained and if changes can be sustained over the longer term. Future work should consider the equity impacts of specific salt reduction programs.

Association Between DNA Methylation and Blood Pressure: A 5-Year Longitudinal Twin Study

“…Factors including an increase in dietary salt, age over 60+ years, obesity, urban residence, low education, and high income were identified to be associated with an increased probability of exacerbation of hypertension status. 15,62–64 The findings from these studies indicated the implications of exploring the factors influencing the progression of hypertension severity. The current study is the first to assess the influence of DNA methylation.…”

Estimated Impact of Achieving the Australian National Sodium Reduction Targets on Blood Pressure, Chronic Kidney Disease Burden and Healthcare Costs: A Modelling Study

“…Despite compelling evidence on the relationship between dietary sodium, BP and CKD, few studies have assessed the long-term impact of sodium reduction on CKD burden [ 12 ]. Most modelling studies globally [ 13 , 14 , 15 , 16 , 17 ] and in Australia [ 18 , 19 ] have either focused on the impact on heart disease and stroke or did not explore the longer-term impacts on CKD [ 20 ]. This implies the currently reported health impacts of sodium reduction in Australia are likely underestimated.…”

Avoidable burden of stomach cancer and potential gains in healthy life years from gradual reductions in salt consumption in Vietnam, 2019 – 2030: a modelling study

“…The most recent World Health Organization (WHO) STEPS survey in Vietnam estimated that adults consume on average 9.4 grams of salt per day (10), which is about double the current WHO recommendation of <5g/day (11). Existing research on the harmful effects of high salt intake globally (12) and in Vietnam (13, 14) has mostly focused on its impact on blood pressure and cardiovascular disease. The impact of such high salt diets on the burden of stomach cancer has not been evaluated in Vietnam.…”