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Study Shows Collaborative Strategies to Reduce Sodium Should Positively Impact Heart Attack and Stroke Rates

April 5, 2010

A new study by researchers at the Veterans Affairs Palo Alto Health Care System has show that strategies to reduce sodium intake are likely to reduce the incidence of stroke and heart attack, which could, in turn, potentially save up to $32.1 billion in direct medical costs.

The study, conducted by VA HSR&D investigator Crystal Smith-Spangler, MD, examined two strategies designed to reduce sodium intake: industry collaboration and a tax on sodium. For the first strategy, investigators used a computerized model that simulates the effects of reduced sodium intake on a large population of people between the ages of 40 and 85. Based on a similar salt-reduction campaign in the United Kingdom, the researchers estimated that a collaborative effort between government and the food industry could lead to a 9.5 percent decline in Americans' salt intake—enough to reduce blood pressure by a modest 1.25 millimeters of mercury (mmHg) in the age group studied. This reduction would, in turn, lead to a modest decline in blood pressure, potentially averting 513,885 strokes and 480,358 myocardial infarctions (MIs) over the lifetime of adults age 40-85. This also would increase quality-adjusted life years (QALYs) by 1.3 million and save $32.1 billion in direct medical costs.

The researchers also estimated the impact of a tax on sodium. Results showed a slightly lower, but still significant, impact of a 6 percent decrease in salt intake, and a 0.93 mmHg reduction in blood pressure. Investigators calculated that such a reduction would result in 327,892 fewer strokes and 306,173 fewer heart attacks.

The findings are published in the March 2 issue of Annals of Internal Medicine.

Dr. Smith-Spangler was supported by a VA Special Fellowship in Health Services Research. Drs. Smith-Spangler, Owens, and Garber are part of the VA Palo Alto Healthcare System. Drs. Owens and Garber also are part of HSR&D's Center for Health Care Evaluation in Palo Alto, CA.

Smith-Spangler C, Juusola J, Enns E, Owens D, and Garber A. Population Strategies to Decrease Sodium Intake and the Burden of Cardiovascular Disease in the United States, a Cost-Effectiveness Anaylsis. Annals of Internal Medicine March