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Reducing salt 1g daily in China could prevent ~9M cardiovascular events by 2030

Introduction In China, salt intake is among the highest in the world (~11 g/day) and cardiovascular disease (CVD) accounts for 40% of deaths. We estimated the potential impact of reducing salt intake on CVD events in China, via systolic blood pressure (SBP). Methods To develop our model, we extracted the effect of salt reduction on SBP from a meta-regression of randomised trials and a population study, and that of SBP on CVD risk from pooled cohort studies. Results Reducing population salt intake in China by 1 g/day could lower the risk for ischaemic heart disease by about 4% (95% uncertainty interval 1.8%–7.7%) and the risk for stroke by about 6% (2.4%–9.3%). Should this reduced salt level be sustained until 2030,~9 million (M) (7M–10.8M) CVD events could be prevented, of which ~4M (3.1M–4.9M) would have been fatal. Greater and gradual salt intake reductions, to achieve WHO’s target of 30% reduction by 2025 or the Chinese government’s target of ≤5 g/day by 2030, could prevent ~1.5 or 2 times more CVD events and deaths, respectively. Should the prolonged effect of salt reduction over several years be accounted for, all estimates of CVD events and deaths prevented would be 25% greater on average. Conclusion Bringing down the high salt intake levels in China could result in large reductions in CVD. An easily achievable reduction of 1 g/day could prevent ~9M CVD events by 2030. Urgent action must be taken to reduce salt intake in China. Data are available on reasonable request. Requests for access to data and statistical code should be addressed to MT.

The aim of this study is to estimate the potential impact of reducing salt intake on stroke and ischaemic heart disease events (IHD) in China, using the latest and most robust data sources available. Baseline data for population size, salt intake (24-hour urinary sodium excretion), blood pressure and disease rates were taken from the latest and most robust figures available ( online supplemental table 1). 8 40 Health education can effectively lead to behaviour change, as shown in the trial in Northern China of a school-based programme, which was successful in reducing salt intake in both schoolchildren and their families.

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