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Cardiac risk factors and prevention
Original research article
Potential impact of a modest reduction in salt intake on blood pressure, cardiovascular disease burden and premature mortality: a modelling study
  1. Leopold Ndemnge Aminde1,2,
  2. Linda J Cobiac3 and
  3. J Lennert Veerman1,4
  1. 1 Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 Non-communicable Diseases Unit, Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon
  3. 3 Nuffield Department of Population Health, University of Oxford, Oxford, UK
  4. 4 School of Medicine, Griffith University, Gold Coast, Queensland, Australia
  1. Correspondence to Dr Leopold Ndemnge Aminde; l.aminde{at}uq.net.au

Abstract

Objective To assess the potential impact of reduction in salt intake on the burden of cardiovascular disease (CVD) and premature mortality in Cameroon.

Methods Using a multicohort proportional multistate life table model with Markov process, we modelled the impact of WHO’s recommended 30% relative reduction in population-wide sodium intake on the CVD burden for Cameroonian adults alive in 2016. Deterministic and probabilistic sensitivity analyses were conducted and used to quantify uncertainty.

Results Over the lifetime, incidence is predicted to decrease by 5.2% (95% uncertainty interval (UI) 4.6 to 5.7) for ischaemic heart disease (IHD), 6.6% (95% UI 5.9 to 7.4) for haemorrhagic strokes, 4.8% (95% UI 4.2 to 5.4) for ischaemic strokes and 12.9% (95% UI 12.4 to 13.5) for hypertensive heart disease (HHD). Mortality over the lifetime is projected to reduce by 5.1% (95% UI 4.5 to 5.6) for IHD, by 6.9% (95% UI 6.1 to 7.7) for haemorrhagic stroke, by 4.5% (95% UI 4.0 to 5.1) for ischaemic stroke and by 13.3% (95% UI 12.9 to 13.7) for HHD. About 776 400 (95% UI 712 600 to 841 200) health-adjusted life years could be gained, and life expectancy might increase by 0.23 years and 0.20 years for men and women, respectively. A projected 16.8% change (reduction) between 2016 and 2030 in probability of premature mortality due to CVD would occur if population salt reduction recommended by WHO is attained.

Conclusion Achieving the 30% reduction in sodium intake recommended by WHO could considerably decrease the burden of CVD. Targeting blood pressure via decreasing population salt intake could translate in significant reductions in premature CVD mortality in Cameroon by 2030.

  • heart disease
  • stroke
  • sodium
  • prevention
  • burden of disease

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/openhrt-2018-000943

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    Footnotes

    • Contributors LNA conceived the study, did the modeling analysis and wrote the first version of the manuscript. LJC and JLV contributed to analysis, interpretation of findings and reviewed successive versions of the manuscript. All authors critically reviewed the manuscript and approved the final version for publication.

    • Funding Leopold N. Aminde is supported by the Australian Government Research Training Program (RTP) Scholarship Award.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the School of Public Health Research Ethics Committee of the University of Queensland, Australia (no. 1708).

    • Provenance and peer review Not commissioned; externally peer reviewed.