Modelling the cardiovascular health outcomes of the UK salt reduction targets

BackgroundExcessive sodium intake is responsible for three million deaths a year globally. The UK is one of 64 countries to have a salt reduction programme to help reduce the populations sodium intake. It is a voluntary scheme with 108 category-specific salt content targets for the grocery and out of home sectors. The aim of this study was to estimate the potential impact of these targets on cardiovascular outcomes and healthcare costs for UK adults. MethodsLong-term health modelling was based on the adult population in England. Changes in salt intake (grams/day) were estimated using consumption data from the National Diet and Nutrition Survey 2017/18. Impact on ischaemic heart disease (IHD) and stroke, QALYs and healthcare costs were estimated using PRIMEtime, a proportional multistate lifetable model. ResultsIf the salt reduction targets set for 2024 were met, then salt intake would reduce from 6.06g/day (95% CI 5.18 - 6.31) to 4.94g/day (4.73 - 5.15), a reduction of 1.12g/day (1.05 - 1.20). This would lead to 103,000 (UI 41,000-161,000) fewer cases of IHD and 25,000 (10,000 - 39,000) fewer cases of stroke over 20 years. A modelled 243,000 (94,000-383,000) QALYs would be saved with a net saving of {pound}1.00 billion ({pound}0.35-1.73 billion)) to the NHS over the remaining lifetime of the adult population. DiscussionReformulation of products to meet the targets could result in substantial reductions in cardiovascular disease without changes in dietary behaviours. Policymakers should consider options to strengthen salt reduction policies, including effective systems for monitoring and enforcement.