Joffres Michel R, Campbell Norm R C, Manns Braden, Tu Karen
Simon Fraser University, Burnaby, British Columbia, Canada.
Can J Cardiol. 2007 May 1;23(6):437-43. doi: 10.1016/s0828-282x(07)70780-8.
Hypertension is the leading risk factor for mortality worldwide. One-quarter of the adult Canadian population has hypertension, and more than 90% of the population is estimated to develop hypertension if they live an average lifespan. Reductions in dietary sodium additives significantly lower systolic and diastolic blood pressure, and population reductions in dietary sodium are recommended by major scientific and public health organizations.
To estimate the reduction in hypertension prevalence and specific hypertension management cost savings associated with a population-wide reduction in dietary sodium additives.
Based on data from clinical trials, reducing dietary sodium additives by 1840 mg/day would result in a decrease of 5.06 mmHg (systolic) and 2.7 mmHg (diastolic) blood pressures. Using Canadian Heart Health Survey data, the resulting reduction in hypertension was estimated. Costs of laboratory testing and physician visits were based on 2001 to 2003 Ontario Health Insurance Plan data, and the number of physician visits and costs of medications for patients with hypertension were taken from 2003 IMS Canada. To estimate the reduction in total physician visits and laboratory costs, current estimates of aware hypertensive patients in Canada were used from the Canadian Community Health Survey.
Reducing dietary sodium additives may decrease hypertension prevalence by 30%, resulting in one million fewer hypertensive patients in Canada, and almost double the treatment and control rate. Direct cost savings related to fewer physician visits, laboratory tests and lower medication use are estimated to be approximately $430 million per year. Physician visits and laboratory costs would decrease by 6.5%, and 23% fewer treated hypertensive patients would require medications for control of blood pressure.
Based on these estimates, lowering dietary sodium additives would lead to a large reduction in hypertension prevalence and result in health care cost savings in Canada.
高血压是全球死亡的主要风险因素。四分之一的加拿大成年人口患有高血压，据估计，如果平均寿命，超过90%的人口会患高血压。减少膳食钠添加剂可显著降低收缩压和舒张压，主要科学和公共卫生组织建议减少人群膳食钠摄入量。
评估在人群中减少膳食钠添加剂与高血压患病率降低以及特定高血压管理成本节省之间的关系。
根据临床试验数据，每天减少1840毫克膳食钠添加剂可使收缩压降低5.06毫米汞柱，舒张压降低2.7毫米汞柱。利用加拿大心脏健康调查数据，估计由此导致的高血压患病率降低情况。实验室检测和医生诊疗费用基于2001年至2003年安大略省医疗保险计划数据，高血压患者的医生诊疗次数和药物费用取自2003年加拿大IMS公司的数据。为了估计医生诊疗总次数和实验室成本的降低情况，使用了加拿大社区健康调查中加拿大已知高血压患者的当前估计数。
减少膳食钠添加剂可能使高血压患病率降低30%，加拿大高血压患者减少100万，治疗和控制率几乎翻倍。与医生诊疗次数减少、实验室检测减少和药物使用降低相关的直接成本节省估计每年约为4.3亿美元。医生诊疗和实验室成本将降低6.5%，接受治疗的高血压患者中需要药物控制血压的人数将减少23%。
基于这些估计，降低膳食钠添加剂将导致加拿大高血压患病率大幅降低，并节省医疗保健成本。
