Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada
Open accessAbstract
Background Hypertension is the leading risk factor for mortality worldwide. One-quarter of the adult Canadian population has hypertension, and more than 90% of the population is estimated to develop hypertension if they live an average lifespan. Reductions in dietary sodium additives significantly lower systolic and diastolic blood pressure, and population reductions in dietary sodium are recommended by major scientific and public health organizations.Objectives To estimate the reduction in hypertension prevalence and specific hypertension management cost savings associated with a population-wide reduction in dietary sodium additives.Methods Based on data from clinical trials, reducing dietary sodium additives by 1840 mg/day would result in a decrease of 5.06 mmHg (systolic) and 2.7 mmHg (diastolic) blood pressures. Using Canadian Heart Health Survey data, the resulting reduction in hypertension was estimated. Costs of laboratory testing and physician visits were based on 2001 to 2003 Ontario Health Insurance Plan data, and the number of physician visits and costs of medications for patients with hypertension were taken from 2003 IMS Canada. To estimate the reduction in total physician visits and laboratory costs, current estimates of aware hypertensive patients in Canada were used from the Canadian Community Health Survey.Results Reducing dietary sodium additives may decrease hypertension prevalence by 30%, resulting in one million fewer hypertensive patients in Canada, and almost double the treatment and control rate. Direct cost savings related to fewer physician visits, laboratory tests and lower medication use are estimated to be approximately $430 million per year. Physician visits and laboratory costs would decrease by 6.5%, and 23% fewer treated hypertensive patients would require medications for control of blood pressure.Conclusions Based on these estimates, lowering dietary sodium additives would lead to a large reduction in hypertension prevalence and result in health care cost savings in Canada.
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About 30% of hypertension is related to increased sodium (salt) consumption, and about 20% related to low dietary potassium (low fruit and vegetable intake).
“About 30% of hypertension is related to increased sodium (salt) consumption, and about 20% related to low dietary potassium (low fruit and vegetable intake).”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [19]
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Cites
Global burden of hypertension: analysis of worldwide data
Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. K., & He, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)17741-1 · Cited by 8,578 · see citing works
Intravenous Fluids and Acute Kidney Injury
Ding, X., Cheng, Z., & Qian, Q. (2017) · Blood Purification · doi:10.1159/000452702 · Cited by 6,866 · see citing works
The World Health Report 2002 - Reducing Risks, Promoting Healthy Life
Available, N. A. N. (2003) · Education for Health · doi:10.1080/1357628031000116808 · Cited by 6,051 · see citing works
AMERICAN PUBLIC HEALTH ASSOCIATION
Probst, C. O. (1910) · JAMA · doi:10.1001/jama.1910.04330120065030 · Cited by 4,296 · see citing works
Selected major risk factors and global and regional burden of disease
Ezzati, M., Lopez, A. D., Rodgers, A., Vander Hoorn, S., & Murray, C. J. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11403-6 · Cited by 3,594 · see citing works
Global burden of hypertension: analysis of worldwide data
(2005) · doi:10.1016/s0140-6736(05)70151-3 · Cited by 3,289 · see citing works
Guidelines Committee (2003) · Journal of Hypertension · doi:10.1097/00004872-200306000-00001 · Cited by 3,015 · see citing works
Mancia, G., Rosei, E. A., Cífková, R., DeBacker, G., Erdine, S. E., Fagard, R., Farsang, C., Heagerty, A. M., Kawecka-Jaszcs, K., Kiowski, W., et al. (2003) · Lirias (KU Leuven) · doi:10.1097/01.hjh.0000059051.65882.32 · Cited by 2,601 · see citing works
Hajjar, I. M. (2003) · JAMA · doi:10.1001/jama.290.2.199 · Cited by 2,399 · see citing works
Wolf-Maier, K. (2003) · JAMA · doi:10.1001/jama.289.18.2363 · Cited by 1,718 · see citing works
Whelton, P. K. (2002) · JAMA · doi:10.1001/jama.288.15.1882 · Cited by 1,466 · see citing works
Residual Lifetime Risk for Developing Hypertension in Middle-aged Women and Men
Vasan, R. S., Beiser, A., Seshadri, S. S., Larson, M. G., Kannel, W. B., D’Agostino, R. B., & Levy, D. A. (2002) · JAMA · doi:10.1001/jama.287.8.1003 · Cited by 1,399 · see citing works
Appel, L. J., Brands, M. W., Daniels, S. R., Karanja, N., Elmer, P. J., & Sacks, F. M. (2006) · Hypertension · doi:10.1161/01.hyp.0000202568.01167.b6 · Cited by 1,304 · see citing works
Hux, J. E., Ivis, F. J., Flintoft, V. F., & Bica, A. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.512 · Cited by 1,290 · see citing works
Williams, B., Poulter, N. R., Brown, M. J., Davis, M., McInnes, G. T., POTTER, J. F., Sever, P. S., & Thom, S. (2004) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001683 · Cited by 1,262 · see citing works
Law, M. R., Wald, N. J., Morris, J. K., & Jordan, R. E. (2003) · BMJ · doi:10.1136/bmj.326.7404.1427 · Cited by 1,232 · see citing works
Cook, N. R., Cutler, J. A., Obarzanek, E., Buring, J. E., Rexrode, K. M., Kumanyika, S. K., Appel, L. J., & Whelton, P. K. (2007) · BMJ · doi:10.1136/bmj.39147.604896.55 · Cited by 1,179 · see citing works
Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate
Institute of Medicine (2005) · National Academies Press eBooks · doi:10.17226/10925 · Cited by 1,054 · see citing works
Implications of Small Reductions in Diastolic Blood Pressure for Primary Prevention
Cook, N. R. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430070053006 · Cited by 828 · see citing works
Dickinson, H. O., Mason, J. M., Nicolson, D. J., Campbell, F., Beyer, F. R., Cook, J. V., Williams, B., & Ford, G. A. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000199800.72563.26 · Cited by 759 · see citing works
Effect of longer-term modest salt reduction on blood pressure
He, F. J., Li, J., & MacGregor, G. A. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004937.pub2 · Cited by 737 · see citing works
Relative contributions of dietary sodium sources
Mattes, R. D., & Donnelly, D. (1991) · Journal of the American College of Nutrition · doi:10.1080/07315724.1991.10718167 · Cited by 595 · see citing works
Accuracy of administrative databases in identifying patients with hypertension.
Tu, K., Campbell, N. R. C., Chen, Z., Cauch‐Dudek, K., & McAlister, F. A. (2007) · PubMed Central · Cited by 553 · see citing works
Self-citationIncreased Absenteeism from Work after Detection and Labeling of Hypertensive Patients
Haynes, R. B., Sackett, D. L., Taylor, D. W., Gibson, E. S., & Johnson, A. L. (1978) · New England Journal of Medicine · doi:10.1056/nejm197810052991403 · Cited by 511 · see citing works
Sodium Intake and Hypertension
Karppanen, H., & Mervaala, E. M. A. (2006) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2006.07.001 · Cited by 483 · see citing works
Importance of Salt in Determining Blood Pressure in Children
He, F. J., & MacGregor, G. A. (2006) · Hypertension · doi:10.1161/01.hyp.0000245672.27270.4a · Cited by 406 · see citing works
Canadian community health survey--methodological overview.
Béland, Y. (2002) · PubMed · Cited by 389 · see citing works
How Far Should Salt Intake Be Reduced?
He, F. J., & MacGregor, G. A. (2003) · Hypertension · doi:10.1161/01.hyp.0000102864.05174.e8 · Cited by 379 · see citing works
Awareness, Treatment, and Control of Hypertension in Canada
Joffres, M. (1997) · American Journal of Hypertension · doi:10.1016/s0895-7061(97)00224-0 · Cited by 350 · see citing works
Self-citationSystematic review of long term effects of advice to reduce dietary salt in adults
Hooper, L., Bartlett, C., Smith, G. D., & Ebrahim, S. B. J. (2002) · BMJ · doi:10.1136/bmj.325.7365.628 · Cited by 299 · see citing works
Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men
Chang, H., Hu, Y.-W., Yue, C.-S. J., Wen, Y., Yeh, W., Hsu, L.-S., Tsai, S.-Y., & Pan, W. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/83.6.1289 · Cited by 298 · see citing works
Individual Blood Pressure Responses to Changes in Salt Intake
Obarzanek, E., Proschan, M. A., Vollmer, W. M., Moore, T. J., Sacks, F. M., Appel, L. J., Svetkey, L. P., Most-Windhauser, M. M., & Cutler, J. A. (2003) · Hypertension · doi:10.1161/01.hyp.0000091267.39066.72 · Cited by 197 · see citing works
Blood pressure and the global burden of disease 2000. Part 1: Estimates of blood pressure levels
Lawes, C. M. M., Hoorn, S. V., Law, M. R., Elliott, P., MacMahon, S. W., & Rodgers, A. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000199801.72563.6f · Cited by 159 · see citing works
Joffres, M. R., Hamet, P., Rabkin, S. W., Gelskey, D. E., Hogan, K. P., & Fodor, G. J. (1992) · Europe PMC (PubMed Central) · Cited by 148 · see citing works
Self-citationReducing the Population Burden of Cardiovascular Disease by Reducing Sodium Intake
Dickinson, B. D. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.14.1460 · Cited by 146 · see citing works
Khan, N. A., McAlister, F. A., Rabkin, S. W., Padwal, R. S., Feldman, R. D., Campbell, N. R. C., Leiter, L. A., Lewanczuk, R. Z., Schiffrin, E. L., Hill, M. D., et al. (2006) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(06)70280-x · Cited by 143 · see citing works
Self-citationPopulation-based study of repeat laboratory testing.
van Walraven, C., & Raymond, M. (2003) · Clinical Chemistry · doi:10.1373/clinchem.2003.021220 · Cited by 137 · see citing works
Singh, M. K. (2003) · Nutrition Bulletin · doi:10.1046/j.1467-3010.2003.00351.x · Cited by 136 · see citing works
Effect of Population-Based Interventions on Laboratory Utilization
van Walraven, C., Goel, V., & Chan, B. (1998) · JAMA · doi:10.1001/jama.280.23.2028 · Cited by 129 · see citing works
MacLean, D. R., Petrasovits, A., Nargundkar, M., Connelly, P. W., MacLeod, E., Edwards, A., & Hessel, P. (1992) · Europe PMC (PubMed Central) · Cited by 98 · see citing works
Onysko, J., Maxwell, C. J., Eliasziw, M., Zhang, J. X., Johansen, H., & Campbell, N. R. C. (2006) · Hypertension · doi:10.1161/01.hyp.0000242335.32890.c6 · Cited by 89 · see citing works
Self-citationReport of the Canadian Hypertension Society Consensus Conference: 1. Introduction.
Carruthers, S. G., Larochelle, P. M., Haynes, R. B., Petrasovits, A., & Schiffrin, E. L. (1993) · Europe PMC (PubMed Central) · Cited by 81 · see citing works
Hypertension Management in the Elderly Has Improved
Tu, K., Campbell, N. R. C., Duong-Hua, M., & McAlister, F. A. (2005) · Hypertension · doi:10.1161/01.hyp.0000164573.01177.95 · Cited by 57 · see citing works
Self-citationThe Influence of Dietary Sodium on Blood Pressure
Hollenberg, N. K. (2006) · Journal of the American College of Nutrition · doi:10.1080/07315724.2006.10719573 · Cited by 33 · see citing works
Victoria Declaration on Heart Health
Farquhar, J. W., MacLean, D. R., Balram, B. C., et al. (1992) · Canadian Medical Association Journal · Cited by 32 · see citing works
Impending global pandemic of cardiovascular diseases
Achutti, A., Balaguer-Vintró, I., Luna, A., Chalmers, J. D., Chockalingam, A., Farinaro, E., Lauzon, R. R. I., Martín, I., Papp, J., Postiglone, A., et al. (1999) · Cited by 30 · see citing works
Management of hypertension in low and middle income countries: Challenges and opportunities
Mohan, S., Campbell, N. R. C., & Chockalingam, A. (2005) · Global Heart · doi:10.1016/j.precon.2006.04.001 · Cited by 12 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Advisory Board of the Second International Heart Health Conference. The Catalonia Declaration. Investing in heart health. 1995:1-85. <www.internationalhearthealth.org/Publications/ catalonia1995.pdf> (Version current at March 9, 2007).
Cited by
Sorted by citations
Priority actions for the non-communicable disease crisis
Beaglehole, R., Bonita, R., Horton, R., Adams, C., Alleyne, G., Asaria, P., Baugh, V., Bekedam, H., Billo, N., Casswell, S., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60393-0 · Cited by 1,615 · see citing works
He, F. J., Li, J., & MacGregor, G. A. (2013) · BMJ · doi:10.1136/bmj.f1325 · Cited by 1,358 · see citing works
He, F. J., & MacGregor, G. A. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2008.144 · Cited by 1,123 · see citing works
Reducing population salt intake worldwide: from evidence to implementation
He, F. J., & MacGregor, G. A. (2010) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2009.12.006 · Cited by 625 · see citing works
Diet and Lifestyle Risk Factors Associated With Incident Hypertension in Women
Forman, J. P. (2009) · JAMA · doi:10.1001/jama.2009.1060 · Cited by 555 · see citing works
Joffres, M., Falaschetti, E., Gillespie, C., Robitaille, C., Loustalot, F., Poulter, N., McAlister, F. A., Johansen, H., Baclic, O., & Campbell, N. (2013) · BMJ Open · doi:10.1136/bmjopen-2013-003423 · Cited by 464 · see citing works
Self-citationSalt and hypertension: is salt dietary reduction worth the effort?
Frisoli, T. M., Schmieder, R. E., Grodzicki, T., & Messerli, F. H. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.10.023 · Cited by 200 · see citing works
Padwal, R., Campbell, N. R. C., Schutte, A. E., Olsen, M. H., Delles, C., Etyang, A., Cruickshank, J. K., Stergiou, G., Rakotz, M. K., Wozniak, G., et al. (2019) · Journal of Hypertension · doi:10.1097/hjh.0000000000002112 · Cited by 108 · see citing works
Self-citationMillett, C., Laverty, A. A., Stylianou, N., Bibbins-Domingo, K., & Pape, U. J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0029836 · Cited by 87 · see citing works
Sodium intake and physical activity impact cognitive maintenance in older adults: the NuAge Study
Fiocco, A. J., Shatenstein, B., Ferland, G., Payette, H., Belleville, S., Kergoat, M.-J., Morais, J. A., & Greenwood, C. E. (2012) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2011.07.004 · Cited by 84 · see citing works
Automated blood pressure measuring devices: how are they clinically validated for accuracy?
Ringrose, J. S., & Padwal, R. (2022) · Journal of Human Hypertension · doi:10.1038/s41371-022-00761-2 · Cited by 9 · see citing works
- Authors
- Joffres, M. R., Campbell, N. R. C., Manns, B., & Tu, K.
- Affiliations
- Simon Fraser University (CA)
- Libin Cardiovascular Institute of Alberta (CA)
- University of Calgary (CA)
- University Health Network (CA)
- Corresponding author
- Campbell, Norm R.C.
- Venue
- Canadian Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-05
- Volume
- 23
- Issue
- 6
- Pages
- 437-443
- ISSN
- 0828-282X (ISSN-L)
- PMC
- PMC2650661
- OpenAlex
- W1995049482
- Cited by
- 197
- References
- 49
- Citations by year
- 2026: 2 · 2024: 5 · 2023: 1 · 2022: 8 · 2021: 12 · 2020: 9 · 2019: 9 · 2018: 8 · 2017: 14 · 2016: 8 · 2015: 10 · 2014: 13 · 2013: 15 · 2012: 20
- FWCI
- 11.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Canadian Journal of Cardiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- Hypertension Canada
- Health Canada
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertension, blood pressure reduction, hypertension prevalence, healthcare cost reduction, physician visits, laboratory testing costs, antihypertensive medication use, Canada
- MeSH terms
- Canada, Cost-Benefit Analysis, Diet, Sodium-Restricted, Health Promotion, Health Surveys, Humans, Hypertension, Nutritional Requirements, Population Surveillance, Sodium, Dietary, Prevalence, Health Care Costs
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