NICE Public Health Guidance: Prevention of Cardiovascular Disease
Extracted from: Population-level approaches: cost effectiveness
The financial modelling for this guidance shows that considerable cost savings could be made. Using a number of conservative assumptions, it found that halving CVD events across England and Wales (a population of 50 million) would result in discounted savings in healthcare costs of approximately £14 billion per year. Reducing mean population cholesterol or blood pressure levels by 5% would result in discounted annual savings of approximately £0.7 billion and £0.9 billion respectively. Reducing population cardiovascular risk by even 1% would generate discounted savings of approximately £260 million per year.
A 3 g reduction in mean daily salt intake by adults (to achieve a target of 6 g daily) would lead to around 14–20,000 fewer deaths from CVD annually (Strazzullo et al. 2009). Using conservative assumptions, this means approximately £350 million in healthcare costs would be saved. In addition, approximately 130,000 quality-adjusted life years (QALYs) would be gained. A mean reduction of 6 g per day would double the benefits: an annual saving of £700 million in healthcare costs and a gain of around 260,000 QALYs. A 3 g reduction in daily salt intake (a reasonably conservative estimate of what could be achieved) would reduce systolic blood pressure by approximately 2 mmHg. This would equate to a 2% decrease in the risk reduction model. Similarly, a reduction of IPTFA intake to approximately 0.7% of total fat energy might save approximately 571,000 life years – and some £2 billion.
Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009;339:b4567
A meta-analysis of prospective studies on salt intake, stroke, and cardiovascular disease has made the case for population-wide salt reduction even stronger. The analysis, by Professor Strazzullo and Professor Cappuccio published in the British Medical Journal in November 2009 shows that a difference of 5 g a day in habitual salt intake is associated with a 23% difference in the rate of stroke and a 17% difference in the rate of total cardiovascular disease.
Based on these results, reducing daily salt intake by 5 g at the population level could avert one and a quarter million deaths from stroke and almost three million deaths from cardiovascular disease each year.
Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. Bibbins-Domingo et al. N Engl J Med 2010.
A paper published in the USA by Bibbins-Domingo et al published in the New England Journal of Medicine makes for a further compelling case for salt reduction throughout the world. The paper emphasises the enormous public health benefits, and medical cost reductions, of salt reduction on cardiovascular disease.