Projected Impact of Salt Restriction on Prevention of Cardiovascular Disease in China: A Modeling Study

Objectives

To estimate the effects of achieving China’s national goals for dietary salt (NaCl) reduction or implementing culturally-tailored dietary salt restriction strategies on cardiovascular disease (CVD) prevention.

Methods

The CVD Policy Model was used to project blood pressure lowering and subsequent downstream prevented CVD that could be achieved by population-wide salt restriction in China. Outcomes were annual CVD events prevented, relative reductions in rates of CVD incidence and mortality, quality-adjusted life-years (QALYs) gained, and CVD treatment costs saved.

Results

Reducing mean dietary salt intake to 9.0 g/day gradually over 10 years could prevent approximately 197 000 incident annual CVD events [95% uncertainty interval (UI): 173 000–219 000], reduce annual CVD mortality by approximately 2.5% (2.2–2.8%), gain 303 000 annual QALYs (278 000–329 000), and save approximately 1.4 billion international dollars (Int$) in annual CVD costs (Int$; 1.2–1.6 billion). Reducing mean salt intake to 6.0 g/day could approximately double these benefits. Implementing cooking salt-restriction spoons could prevent 183 000 fewer incident CVD cases (153 000–215 000) and avoid Int$1.4 billion in CVD treatment costs annually (1.2–1.7 billion). Implementing a cooking salt substitute strategy could lead to approximately three times the health benefits of the salt-restriction spoon program. More than three-quarters of benefits from any dietary salt reduction strategy would be realized in hypertensive adults.

Conclusion

China could derive substantial health gains from implementation of population-wide dietary salt reduction policies. Most health benefits from any dietary salt reduction program would be realized in adults with hypertension.     

Distribution and characterization of Aegilops and Triticum species from the Bulgarian Black Sea coast

A total of 158 Aegilops-Triticum samples representing six Aegilops species (one diploid, four tetraploid and one hexaploid) and one diploid Triticum were collected along the Bulgarian Black Sea coast, and their distribution on the 350 km long coastal line was reported. The region south of Kamchia river, accepted as the middle point of the coast, was characterized by the greatest diversity of these wild relatives of wheat. The most widely distributed species in this area was Ae. geniculata. Ae. cylindrica was distributed only in north (Durankulak), while Ae. biuncialis and Ae. triuncialis were collected both north and south of Kamchia river. All samples of Ae. neglecta were hexaploid. Natural hybrids of goatgrass and wheat were found in Ae. cylindrica populations. Triticum monococcum ssp. aegilopoides had limited distribution in the south region. Aegilops uniaristata was recorded as a new species for the Bulgarian flora. Most of the samples expressed resistance to powdery mildew in seedling and adult stage, but all of them were polymorphic regarding the resistance to leaf rust (cultures 73760 and 43763). The study revealed additional data for the distribution of Aegilops and Triticum species in Bulgaria and their potential value as genetic resources in wheat improvement.