Mortality benefit from reduction in sodium consumption 1 Hypertension affects one-third of the US population, of which less than half have their blood pressure under control. Studies have demonstrated a positive association between high sodium intake and elevated blood pressure. Less than 12% of adults meet the recommended amount of sodium intake (less than 1500 mg/d): the daily sodium intake in the US has averaged 3600 mg/d over the last 20 years. (80% coming from processed and commercially prepared foods) 1. Coxson PG, Cook NR, Joffres M, et al. Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches. Hypertension. 2013;61:

Collaborative modeling of the effect of population-wide sodium intake reduction on health Effects of a sodium reduction intervention on cardiovascular disease (CVD) were estimated based on the results of the extended follow-up of a randomized clinical trial with sodium restriction intervention. 1 Three scenarios regarding salt restriction were studied: -Scenario A: gradual uniform reduction of salt absorption achieving 40% reduction within 10 years. -Scenario B: immediate 40% reduction in sodium consumption sustained for 10 years. -Scenario C: immediate reduction to 1500 mg/d (recommended level) sustained for 10 years. 1. Cook NR, Cutler JA, Obarzanek E. et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007;334:

Ten-year estimate of cardiovascular disease for each scenario Projected deaths with current sodium consumption95% Confidence interval CHD deaths3800 Stroke deaths821 Major CVD deaths4600 Total deaths Total person-years of life Death prevented and life-years added Scenario A CHD deaths Stroke deaths Major CVD deaths Total deaths Total person-years of life added Scenario B CHD deaths Stroke deaths Major CVD deaths Total deaths Total person-years of life added Scenario C CHD deaths Stroke deaths Major CVD deaths Total deaths Total person-years of life added CHD, coronary heart disease; CVD, cardiovascular disease Current lifestyle Expected effect of the different strategies of salt consumption reduction

Percent change in mortality and cardiovascular events over 10 years CHD, coronary heart disease; CVD, cardiovascular disease

Conclusion This study suggests a substantial benefit for the US population from drastic reduction of salt consumption, Although scenarios B and C are the most effective at protecting individuals against salt-related cardiovascular disease, the strategy of scenario A (40% reduction over a period of 10 years) seems more accessible and should encourage health authorities to support continuous effort aimed at achieving reduction in sodium consumption.