Ferrante Daniel, Konfino Jonatan, Mejía Raúl, Coxson Pamela, Moran Andrew, Goldman Lee, Pérez-Stable Elíseo J
Ministerio de Salud de la Nación, Buenos Aires, Argentina.
Rev Panam Salud Publica. 2012 Oct;32(4):274-80. doi: 10.1590/s1020-49892012001000005.
Estimate the cost-utility ratio of an intervention to reduce dietary salt intake in people over the age of 35 in Argentina.
The intervention consisted of reducing salt content in food by 5% to 25%. A simulation model was used to measure the impact of policies on heart disease in order to predict incidence, prevalence, mortality, and cost trends for heart and cerebrovascular disease in the population aged 35 - 84. The intervention modeled the impact and costs of a 3-gram reduction in dietary salt intake by reducing the amount of salt in processed food and salt added to food by the participants themselves over a 10-year period. Changes in event occurrence during this period and gains in quality-adjusted life years (QALY) were estimated in high- and low-impact scenarios.
The intervention generated a net savings of US$ 3 765 million and a gain of 656 657 QALYs in the high-impact scenario and a savings of US$ 2 080 million and 401 659 QALY in the low-impact scenario. The result would be reductions in the incidence of heart disease (24.1%), acute myocardial infarction (21.6%), and stroke (20.5%), as well as in mortality from heart disease (19.9%) and all causes (6.4%). Benefits were observed for all age groups and both genders.
Implementing this strategy to reduce salt intake would produce a very positive health impact, both in QALY gains and savings in economic resources.
估算在阿根廷对35岁以上人群进行减少膳食盐摄入量干预措施的成本效益比。
干预措施包括将食品中的盐含量降低5%至25%。使用模拟模型来衡量政策对心脏病的影响,以预测35 - 84岁人群中心脏病和脑血管疾病的发病率、患病率、死亡率及成本趋势。该干预通过在10年期间减少加工食品中的盐量以及参与者自身添加到食物中的盐量,来模拟膳食盐摄入量减少3克的影响和成本。在高影响和低影响情景下,估计了这一时期事件发生率的变化以及质量调整生命年(QALY)的增加。
在高影响情景下,干预措施产生了3.765亿美元的净节省和656,657个QALY的增加;在低影响情景下,节省了2.08亿美元和401,659个QALY。结果将使心脏病发病率降低(24.1%)、急性心肌梗死降低(21.6%)、中风降低(20.5%),以及心脏病死亡率降低(19.9%)和全因死亡率降低(6.4%)。所有年龄组和男女均观察到了益处。
实施该减少盐摄入量的策略将在QALY增加和经济资源节省方面产生非常积极的健康影响。