Modelling the impact of compliance with WHO salt recommendations on cardiovascular mortality in Russia

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction High salt intake is considered the primary diet-related risk factor (being responsible for 3 million deaths and 70 million DALYs), because of its association with NCDs, such as cardiovascular diseases (ischemic heart disease, stroke, and hypertension). The World Health Organization (WHO) recommended daily salt intake is known to be <5 g / day (2 g sodium per day). Despite strong evidence indicating that high salt intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. The average amount of salt consumed per day is significantly higher and amounts to 11.35 g/day among Russian adults (2018). The purpose of this study is to model the impact of following the national salt consumption recommendations in decreasing N of death attributable to excessive salt consumption. Methods This study provides a health impact evaluation, which models the effect of sodium reduction on mortality associated with blood pressure and CVD in 2018 in Russia. Cardiovascular disease included coronary heart disease, stroke, hypertensive disease, heart failure, aortic aneurysm, pulmonary embolism and rheumatic heart disease. The observed salt intake from the Russian National Health Survey of 2018 was used to determine the reference (baseline) scenario and the counterfactual scenario considered that average salt consumption was reduced to 5g/day. A comparative risk assessment model, the Preventable Risk Integrated ModEl (PRIME) was used to estimate the deaths from cardiovascular diseases that could be averted or postponed based on the sodium recommendation scenario compared to the baseline scenario. The sensitivity of the model to the results from the meta-analyses was assessed with Monte Carlo simulations. Results In 2018, an estimated 104 602 (95%: 46 832, 154 233) deaths from CVDs could have been prevented if the average salt consumption had been reduced to 5 g/day in Russia. Coronary heart disease (CHD), stroke and hypertensive disease accounted for 97% of these deaths. The modelled reduction in deaths for coronary heart disease was 59 454, for stroke 37 306 and for hypertensive disease 4 833. Conclusion A considerable number of lives could be saved if Russians adhered to the national salt intake recommendations.