Reduction of Cardiovascular Events and Related Healthcare Expenditures through Achieving Population-Level Targets of Dietary Salt Intake in Japan: A Simulation Model Based on the National Health and Nutrition Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Modeling Framework and Study Population
2.2. Scenarios
2.3. Input Parameters
2.4. Model Validation and Sensitivity Analyses
3. Results
3.1. Projected Incidence, Mortality, and National Healthcare Expenditures on the Base Case
3.2. Health Gains by Achieving Dietary Salt Reduction Targets
3.3. National Healthcare Expenditures Saved by Achieving Dietary Salt Reduction Targets
3.4. Sensitivity Analyses
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Input Parameters | Data Sources | Values |
---|---|---|
Total population | Population Estimates [27] | Table S1 |
Mean dietary salt intake | National Health and Nutrition Survey in Japan, 2019 [19] | Table S1 |
Mean SBP | National Health and Nutrition Survey in Japan, 2019 [19] | Table S1 |
Prevalence rates of IHD and stroke | Global Burden of Disease Study 2019 [20] | Table S2 |
Incidence rates of IHD and stroke | Global Burden of Disease Study 2019 [20] | Table S2 |
Mortality rates of IHD, stroke, and all causes | Global Burden of Disease Study 2019 [20] | Table S2 |
Proportion of first-ever events in incident cases | ||
IHD | Japan Thrombosis Registry for Atrial Fibrillation, Coronary, or Cerebrovascular Events (J-TRACE) [30] | Table S3 |
Stroke | Shiga Stroke Registry [31] | Table S3 |
28-day case fatality rates of IHD and stroke | Takashima Cardiovascular Disease Registration System [32] | Table S3 |
Changes in SBP associated with changes in salt intake | Analysis of observational studies in 24 communities [33] | Table S4 |
Relative risks for IHD and stroke associated with SBP | Global Burden of Disease Study 2019 [20] | Table S4 |
National healthcare expenditures | Survey on Medical Care Benefit, 2019 [34], Survey on Prescription Drug Expenditure, 2019 [35] | Table S5 |
Sex, Age (Years) | Population, 2019 | Incidence | Deaths | National Healthcare Expenditures, Million USD | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
IHD | Stroke | IHD | Stroke | Outpatient | Inpatient | ||||||||
No. | No. | (%) | No. | (%) | No. | (%) | No. | (%) | IHD | Stroke | IHD | Stroke | |
Men | |||||||||||||
40–79 | 32,795,000 | 1,322,550 | (4.0) | 1,151,035 | (3.5) | 453,635 | (1.4) | 171,504 | (0.5) | 24,671 | 21,160 | 20,001 | 36,052 |
40–49 | 9,373,000 | 125,027 | (1.3) | 201,224 | (2.1) | 42,884 | (0.5) | 29,982 | (0.3) | 1504 | 2060 | 1314 | 2798 |
50–59 | 8,160,000 | 263,831 | (3.2) | 292,985 | (3.6) | 90,494 | (1.1) | 43,655 | (0.5) | 3560 | 3814 | 3227 | 5418 |
60–69 | 7,930,000 | 403,995 | (5.1) | 340,586 | (4.3) | 138,570 | (1.7) | 50,747 | (0.6) | 7642 | 6298 | 6416 | 10,520 |
70–79 | 7,332,000 | 529,697 | (7.2) | 316,240 | (4.3) | 181,686 | (2.5) | 47,120 | (0.6) | 11,965 | 8989 | 9043 | 17,317 |
Women | |||||||||||||
40–79 | 34,160,000 | 678,243 | (2.0) | 1,444,273 | (4.2) | 293,679 | (0.9) | 226,751 | (0.7) | 11,514 | 21,908 | 5448 | 25,479 |
40–49 | 9,147,000 | 25,083 | (0.3) | 170,857 | (1.9) | 10,861 | (0.1) | 26,825 | (0.3) | 603 | 1855 | 160 | 1842 |
50–59 | 8,118,000 | 64,238 | (0.8) | 291,997 | (3.6) | 27,815 | (0.3) | 45,844 | (0.6) | 1174 | 3608 | 439 | 3267 |
60–69 | 8,302,000 | 171,860 | (2.1) | 443,201 | (5.3) | 74,415 | (0.9) | 69,582 | (0.8) | 2953 | 6421 | 1410 | 6252 |
70–79 | 8,593,000 | 417,062 | (4.9) | 538,218 | (6.3) | 180,588 | (2.1) | 84,500 | (1.0) | 6783 | 10,024 | 3439 | 14,118 |
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Ikeda, N.; Yamashita, H.; Hattori, J.; Kato, H.; Yoshita, K.; Nishi, N. Reduction of Cardiovascular Events and Related Healthcare Expenditures through Achieving Population-Level Targets of Dietary Salt Intake in Japan: A Simulation Model Based on the National Health and Nutrition Survey. Nutrients 2022, 14, 3606. https://doi.org/10.3390/nu14173606
Ikeda N, Yamashita H, Hattori J, Kato H, Yoshita K, Nishi N. Reduction of Cardiovascular Events and Related Healthcare Expenditures through Achieving Population-Level Targets of Dietary Salt Intake in Japan: A Simulation Model Based on the National Health and Nutrition Survey. Nutrients. 2022; 14(17):3606. https://doi.org/10.3390/nu14173606
Chicago/Turabian StyleIkeda, Nayu, Hitomi Yamashita, Jun Hattori, Hiroki Kato, Katsushi Yoshita, and Nobuo Nishi. 2022. "Reduction of Cardiovascular Events and Related Healthcare Expenditures through Achieving Population-Level Targets of Dietary Salt Intake in Japan: A Simulation Model Based on the National Health and Nutrition Survey" Nutrients 14, no. 17: 3606. https://doi.org/10.3390/nu14173606