AUTHOR=Aminde Leopold Ndemnge , Phung Hai N. , Phung Dung , Cobiac Linda J. , Veerman J. Lennert 

TITLE=Dietary Salt Reduction, Prevalence of Hypertension and Avoidable Burden of Stroke in Vietnam: Modelling the Health and Economic Impacts

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.682975

DOI=10.3389/fpubh.2021.682975

ISSN=2296-2565

ABSTRACT=Dietary salt reduction has been recommended as a cost-effective population-wide strategy to prevent cardiovascular disease. The health and economic impact of salt consumption on the future burden of stroke in Vietnam is not known.
Objective: To estimate the avoidable incidence of and deaths from stroke, as well as the healthy life years and healthcare costs that could be gained from reducing salt consumption in Vietnam.
Methods: This was a macrosimulation health and economic impact assessment study. Data on blood pressure, salt consumption and stroke epidemiology were obtained from the Vietnam 2015 STEPS survey and the Global Burden of Disease study. A proportional multi-cohort multistate lifetable Markov model was used to estimate the impact of achieving the Vietnam national salt targets of 8g/day by 2025 and 7g/day by 2030, and to the 5g/day WHO recommendation by 2030. Probabilistic sensitivity analysis was conducted to quantify the uncertainty in our projections.
Results: If the 8g/day, 7g/day and 5g/day targets were achieved, the prevalence of hypertension could reduce by 1·2% (95% uncertainty interval [UI]: 0·5 to 2·3), 2.0% (95%UI: 0·8 to 3·6) and 3·5% (95%UI: 1·5 to 6·3) respectively. This would translate respectively to over 80,000, 180,000 and 257,000 incident strokes and over 18,000, 55,000 and 73,000 stroke deaths averted. By 2025, over 56,554 stroke-related health-adjusted life years (HALYs) could be gained while saving over US$ 42·6 million in stroke healthcare costs. By 2030, about 206,030 HALYs (for 7g/day target) and 262,170 HALYs (for 5g/day target) could be gained while saving over US$ 88·1 million and US$ 122·3 million in stroke healthcare costs respectively. 
Conclusion: Achieving the national salt reduction targets could result in substantial population health and economic benefits. Estimated gains were larger if the WHO salt targets were attained and if changes can be sustained over the longer term. Future work should consider the equity impacts of specific salt reduction programs.