Estimated reductions in cardiovascular and gastric cancer disease burden through salt policies in England: an IMPACTNCD microsimulation study.
BMJ Open
; 7(1): e013791, 2017 01 24.
Article
em En
| MEDLINE
| ID: mdl-28119387
ABSTRACT
OBJECTIVE:
To estimate the impact and equity of existing and potential UK salt reduction policies on primary prevention of cardiovascular disease (CVD) and gastric cancer (GCa) in England.DESIGN:
A microsimulation study of a close-to-reality synthetic population. In the first period, 2003-2015, we compared the impact of current policy against a counterfactual 'no intervention' scenario, which assumed salt consumption persisted at 2003 levels. For 2016-2030, we assumed additional legislative policies could achieve a steeper salt decline and we compared this against the counterfactual scenario that the downward trend in salt consumption observed between 2001 and 2011 would continue up to 2030.SETTING:
Synthetic population with similar characteristics to the non-institutionalised population of England.PARTICIPANTS:
Synthetic individuals with traits informed by the Health Survey for England. MAINMEASURE:
CVD and GCa cases and deaths prevented or postponed, stratified by fifths of socioeconomic status using the Index of Multiple Deprivation.RESULTS:
Since 2003, current salt policies have prevented or postponed â¼52â 000 CVD cases (IQR 34â 000-76â 000) and 10â 000 CVD deaths (IQR 3000-17â 000). In addition, the current policies have prevented â¼5000 new cases of GCa (IQR 2000-7000) resulting in about 2000 fewer deaths (IQR 0-4000). This policy did not reduce socioeconomic inequalities in CVD, and likely increased inequalities in GCa. Additional legislative policies from 2016 could further prevent or postpone â¼19â 000 CVD cases (IQR 8000-30â 000) and 3600 deaths by 2030 (IQR -400-8100) and may reduce inequalities. Similarly for GCa, 1200 cases (IQR -200-3000) and 700 deaths (IQR -900-2300) could be prevented or postponed with a neutral impact on inequalities.CONCLUSIONS:
Current salt reduction policies are powerfully effective in reducing the CVD and GCa burdens overall but fail to reduce the inequalities involved. Additional structural policies could achieve further, more equitable health benefits.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
/
Doenças Cardiovasculares
/
Modelos Estatísticos
/
Cloreto de Sódio na Dieta
/
Política Nutricional
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido