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Oral Abstract Presentations
Outcomes/Clinical Epidemiology

Abstract 028: The Global Impact of Sodium Consumption on Cardiovascular Mortality: A Global, Regional, and National Comparative Risk Assessment

Originally publishedCirculation. 2013;127:A028

    Background. Although sodium (Na) intake increases blood pressure (BP) and is thought to be high in many nations, the global impact of excess Na on BP related CVD is unknown.

    Methods. As part of the 2010 Global Burden of Diseases study, we established a comprehensive compilation of data on Na intake by age, sex, country, and time. From 2007 to 2012, we identified and extracted data from direct contacts on 247 national and subnational surveys worldwide, including 143 of 24-hour urine Na and 104 of estimated dietary Na, in sum representing 66 countries and 74.1% of the world population. We evaluated and adjusted for comparability, assessment methods, and representativeness, and imputed missing values using a Bayesian hierarchical model. We quantified BP effects of Na, including interaction by age, hypertension, and race, in a new meta-analysis of 107 RCTs. Effects of systolic BP on CVD were quantified from large prospective cohorts. Country, age, sex, and cause-specific deaths were obtained from WHO. Impacts of current Na intakes were quantified using comparative risk assessment, vs. a potential optimal intake of 1000 mg/d (2.5 g/d salt), by age, sex, and country.

    Findings. In 2010, mean global Na intake was 4.0 g/d, with regional means ranging from 2.2 to 5.6 g/d. 1.38M (95% CI 0.9, 1.5M) CVD deaths were attributable to excess Na in 2010, 45% due to CHD, 46% to stroke, and 9% other CVD. 55% of these deaths were in men; 45% in women. >80% of deaths were in low and mid-income countries. Among the top 30 most populous nations, highest mortality due to Na was seen in Ukraine (1163 deaths per million adult population), Russia (1006), and China (505); highest proportional mortality in Thailand (18.5% of all CVD deaths attributable to excess Na), China (17.6%), and Korea (17.4%) (Figure). Findings by age and sex will be shown.

    Conclusions. These findings provide the most robust evidence to-date on the global and country-specific impact of excess Na on CVD, directly informing priorities for prevention efforts and policies to reduce global deaths.

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