title: Projected impact of a sodium consumption reduction initiative in Argentina: an analysis from the CVD policy model--Argentina.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of death in adults in Argentina. Sodium reduction policies targeting processed foods were implemented in 2011 in Argentina, but the impact has not been evaluated. The aims of this study are to use Argentina-specific data on sodium excretion and project the impact of Argentina's sodium reduction policies under two scenarios - the 2-year intervention currently being undertaken or a more persistent 10 year sodium reduction strategy.
  
  
  METHODS
  We used Argentina-specific data on sodium excretion by sex and projected the impact of the current strategy on sodium consumption and blood pressure decrease. We assessed the projected impact of sodium reduction policies on CVD using the Cardiovascular Disease (CVD) Policy Model, adapted to Argentina, modeling two alternative policy scenarios over the next decade.
  
  
  RESULTS
  Our study finds that the initiative to reduce sodium consumption currently in place in Argentina will have substantial impact on CVD over the next 10 years. Under the current proposed policy of 2-year sodium reduction, the mean sodium consumption is projected to decrease by 319-387 mg/day. This decrease is expected to translate into an absolute reduction of systolic blood pressure from 0.93 mmHg to 1.81 mmHg. This would avert about 19,000 all-cause mortality, 13,000 total myocardial infarctions, and 10,000 total strokes over the next decade. A more persistent sodium reduction strategy would yield even greater CVD benefits.
  
  
  CONCLUSIONS
  The impact of the Argentinean initiative would be effective in substantially reducing mortality and morbidity from CVD. This paper provides evidence-based support to continue implementing strategies to reduce sodium consumption at a population level.
authors.affiliation: Department of Health, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina ; Directorate of Health Promotion and Control of Non Communicable Diseases, Ministry of Health, Buenos Aires, Argentina.
authors.forename: Jonatan
authors.initials: J
authors.lastname: Konfino
authors.forename: Tekeshe A
authors.initials: TA
authors.lastname: Mekonnen
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Coxson
authors.forename: Daniel
authors.initials: D
authors.lastname: Ferrante
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
mesh_terms: D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008955:Models, Cardiovascular; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000652:urine; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D012982:Sodium, Dietary
references.citation: Cochrane Database Syst Rev. 2004;(3):CD004937
references.pmid: 15266549
references.citation: Intern Med. 2008;47(5):399-403
references.pmid: 18310970
references.citation: Ann Intern Med. 2010 Apr 20;152(8):481-7, W170-3
references.pmid: 20194225
references.citation: Tob Control. 2014 Mar;23(2):e6
references.pmid: 23092886
references.citation: Rev Panam Salud Publica. 2011 Feb;29(2):69-75
references.pmid: 21437363
references.citation: N Engl J Med. 2010 Feb 18;362(7):590-9
references.pmid: 20089957
references.citation: Lancet. 2013 Feb 23;381(9867):670-9
references.pmid: 23410611
references.citation: PLoS Med. 2006 Nov;3(11):e442
references.pmid: 17132052
references.citation: JAMA. 2011 May 4;305(17):1777-85
references.pmid: 21540421
references.citation: J Am Coll Nutr. 1991 Aug;10(4):383-93
references.pmid: 1910064
references.citation: JAMA. 2001 Jul 11;286(2):180-7
references.pmid: 11448281
references.citation: JAMA. 2011 Nov 23;306(20):2229-38
references.pmid: 22110105
references.citation: Lancet. 2005 Jun 25-Jul 1;365(9478):2206-15
references.pmid: 15978929
references.citation: J Hum Hypertens. 2002 Feb;16(2):97-103
references.pmid: 11850766
references.citation: Rev Panam Salud Publica. 2012 Oct;32(4):274-80
references.pmid: 23299288
references.citation: Am J Public Health. 1987 Nov;77(11):1417-26
references.pmid: 3661794
references.citation: Circ Cardiovasc Qual Outcomes. 2010 May;3(3):243-52
references.pmid: 20442213
references.citation: Clin Exp Pharmacol Physiol. 1993 Jan;20(1):7-14
references.pmid: 8432042
references.citation: Stroke. 1991 Mar;22(3):312-8
references.pmid: 2003301
references.citation: Hypertension. 2013 Mar;61(3):564-70
references.pmid: 23399718
references.citation: Int J Cardiol. 2011 Aug 4;150(3):332-7
references.pmid: 21550675
references.citation: Am J Med. 2008 Jan;121(1):58-65
references.pmid: 18187074
references.citation: Hypertens Res. 2006 Jun;29(6):397-402
references.pmid: 16940701
references.citation: Stroke. 2008 Nov;39(11):3036-41
references.pmid: 18703802
references.citation: Popul Health Metr. 2010 May 10;8:9
references.pmid: 20459720
references.citation: Am J Public Health. 1990 Dec;80(12):1481-6
references.pmid: 2240335
references.citation: Am J Clin Nutr. 1997 Feb;65(2 Suppl):626S-642S
references.pmid: 9022559