Three achievable, affordable public health interventions could prevent 94 million early deaths worldwide over the next 25 years, according to a new study.
If there were a global effort to lower blood pressure, reduce sodium intake, and eliminate trans fat, the incidence of premature death from cardiovascular disease would be dramatically reduced, the authors wrote in Circulation: “National and international efforts to scale up these interventions should be a focus of cardiovascular disease prevention programs.”
For their study, the researchers from the Harvard T.H. Chan School of Public Health looked at global data on mean blood pressure levels, sodium and fat intake by age, country and sex from a pooled analysis of population health surveys, regional estimates of current coverage of antihypertensive medications, and cause-specific mortality rates for each country. Additionally, they looked at projections from 2015 to 2040 and used the most recent meta-analyses of epidemiological studies to calculate the relative risk reductions for each intervention.
The authors predict that eliminating trans fats would stave off 14.9 million early deaths while extending high blood pressure treatment to 70 percent of the world’s population could lengthen the lives of nearly 40 million people and reducing sodium intake by 30 percent would hold off some 40 million deaths. This also would help to decrease blood pressure, a known risk factor for cardiovascular disease.
Of all the delayed deaths, more than half are projected to be among men, who develop the greatest numbers of noncommunicable deaths worldwide, according to the researchers. East Asia, the Pacific, South Asia, and countries in sub-Saharan Africa would benefit most from these dietary interventions.
The study has several clinical implications, according to the authors. First, “implementing hypertension diagnosis and control guidelines is key to reducing mortality from cardiovascular diseases globally,” they wrote. Second, “even a lower overage of treatment at 50 percent of patients with diagnosed hypertension would substantially reduce cardiovascular mortality.” Third, “interventions that result in reductions of salt intake can further and substantially reduce the burden of cardiovascular disease.”
To cut back on premature CVD-related deaths, the authors said various programs and policies are needed. While working to implement all three interventions would be a major challenge, earlier analyses indicate that interventions are achievable. In northern California between 2001 and 2013, one Kaiser Permanente program bumped up control of hypertension to 90 percent among the thousands of KP patients. Strategies like patient-friendly services and improved treatment protocol were responsible for the success of this intervention.
What Can Healthcare Practitioners Do?
For healthcare practitioners, the authors call out that increasing the use of blood pressure medicines is a safe and affordable strategy to intervene in CVD deaths.
You should also address nutrition with your patients whenever possible, says study co-author Goodarz Danaei, associate professor of global health at the Harvard T.H. Chan School of Public Health.
“Encouraging patients to reduce salt intake and avoiding products with trans fat are also important health promotion messages,” he adds. For example, “don’t use table salt and don’t use salt during cooking. Use flavors other than salt, such as pepper and lemon juice, and use fresh, flavorful ingredients. Also, avoid products made with trans fats, such as icing on pastries.”