Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.

Reducing salt intake has been proposed to prevent cardiovascular disease in India. We sought to determine whether salt reductions would be beneficial or feasible, given the worry that unrealistically large reductions would be required, worsening iodine deficiency and benefiting only urban subpopulat...

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Main Authors: Sanjay Basu, David Stuckler, Sukumar Vellakkal, Shah Ebrahim
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3435319?pdf=render
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author Sanjay Basu
David Stuckler
Sukumar Vellakkal
Shah Ebrahim
author_facet Sanjay Basu
David Stuckler
Sukumar Vellakkal
Shah Ebrahim
author_sort Sanjay Basu
collection DOAJ
description Reducing salt intake has been proposed to prevent cardiovascular disease in India. We sought to determine whether salt reductions would be beneficial or feasible, given the worry that unrealistically large reductions would be required, worsening iodine deficiency and benefiting only urban subpopulations.Future myocardial infarctions (MI) and strokes in India were predicted with a Markov model simulating men and women aged 40 to 69 in both urban and rural locations, incorporating the risk reduction from lower salt intake. If salt intake does not change, we expect ~8.3 million MIs (95% CI: 6.9-9.6 million), 830,000 strokes (690,000-960,000) and 2.0 million associated deaths (1.5-2.4 million) per year among Indian adults aged 40 to 69 over the next three decades. Reducing intake by 3 g/day over 30 years (-0.1 g/year, 25% reduction) would reduce annual MIs by 350,000 (a 4.6% reduction; 95% CI: 320,000-380,000), strokes by 48,000 (-6.5%; 13,000-83,000) and deaths by 81,000 (-4.9%; 59,000-100,000) among this group. The largest decline in MIs would be among younger urban men, but the greatest number of averted strokes would be among rural men, and nearly one-third of averted strokes and one-fifth of averted MIs would be among rural women. Only under a highly pessimistic scenario would iodine deficiency increase (by <0.0001%, ~1600 persons), since inadequate iodized salt access--not low intake of iodized salt--is the major cause of deficiency and would be unaffected by dietary salt reduction.Modest reductions in salt intake could substantially reduce cardiovascular disease throughout India.
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spelling doaj.art-1143446f94184c7e929a109dc69409a92022-12-21T23:19:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4403710.1371/journal.pone.0044037Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.Sanjay BasuDavid StucklerSukumar VellakkalShah EbrahimReducing salt intake has been proposed to prevent cardiovascular disease in India. We sought to determine whether salt reductions would be beneficial or feasible, given the worry that unrealistically large reductions would be required, worsening iodine deficiency and benefiting only urban subpopulations.Future myocardial infarctions (MI) and strokes in India were predicted with a Markov model simulating men and women aged 40 to 69 in both urban and rural locations, incorporating the risk reduction from lower salt intake. If salt intake does not change, we expect ~8.3 million MIs (95% CI: 6.9-9.6 million), 830,000 strokes (690,000-960,000) and 2.0 million associated deaths (1.5-2.4 million) per year among Indian adults aged 40 to 69 over the next three decades. Reducing intake by 3 g/day over 30 years (-0.1 g/year, 25% reduction) would reduce annual MIs by 350,000 (a 4.6% reduction; 95% CI: 320,000-380,000), strokes by 48,000 (-6.5%; 13,000-83,000) and deaths by 81,000 (-4.9%; 59,000-100,000) among this group. The largest decline in MIs would be among younger urban men, but the greatest number of averted strokes would be among rural men, and nearly one-third of averted strokes and one-fifth of averted MIs would be among rural women. Only under a highly pessimistic scenario would iodine deficiency increase (by <0.0001%, ~1600 persons), since inadequate iodized salt access--not low intake of iodized salt--is the major cause of deficiency and would be unaffected by dietary salt reduction.Modest reductions in salt intake could substantially reduce cardiovascular disease throughout India.http://europepmc.org/articles/PMC3435319?pdf=render
spellingShingle Sanjay Basu
David Stuckler
Sukumar Vellakkal
Shah Ebrahim
Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
PLoS ONE
title Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
title_full Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
title_fullStr Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
title_full_unstemmed Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
title_short Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
title_sort dietary salt reduction and cardiovascular disease rates in india a mathematical model
url http://europepmc.org/articles/PMC3435319?pdf=render
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AT sukumarvellakkal dietarysaltreductionandcardiovasculardiseaseratesinindiaamathematicalmodel
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