Date and Time
April 22, 2009
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Crystal Smith-Spangler

Myocardial infarction (MI) and stroke are leading causes of death in the United States. High blood pressure is a major risk factor for both conditions. Decreasing dietary sodium intake has been shown to reduce blood pressure. Recognizing that even small decreases in blood pressure could significantly reduce MIs and strokes in large populations, several countries, including the US, are considering strategies to decrease population sodium intake. We sought to evaluate the cost-effectiveness of two nationwide strategies to reduce dietary sodium and blood pressure in the US population by comparing costs, quality-adjusted life-years (QALY), and MIs and strokes averted.  Although analyses from other countries have suggested that population strategies to cut sodium intake may be cost-effective, no such analyses have been published evaluating the cost-effectviveness in a US population.

In this presentation, we will discuss two strategies proposed to cut population sodium intake:

1. a United Kingdom (UK)-style program which collaborates with industry to decrease sodium content in processed food; and
   
2. taxation of salt used for food production.

We will present the results of a simulation model we developed to compare the costs and benefits of these strategies to reduce sodium intake and blood pressure among a population of US adults age 40-85 years. We modeled acute MI, acute stroke, death, and the post-MI and post-stroke states using published data from the Framingham Heart Study.   Prelimary findings suggest that both stategies result in lower societal costs with an increase in QALYs. The results critically depend on the effectiveness of each strategy in lowering blood pressure, with the UK strategy estimated to be the most effective.  The main source of cost savings in our model is in preventing future costs associated with the post- MI or post- stroke rather that the acute event hospital costs. The weight of evidence suggests little harm with modest decreases in sodium intake though no long term trials of modest sodium reduction have been completed.