Send to

Choose Destination
J Am Heart Assoc. 2019 Jan 8;8(1):e010737. doi: 10.1161/JAHA.118.010737.

Cardiovascular Diseases Deaths Attributable to High Sodium Intake in Shandong Province, China.

Author information

1 Shandong Province Center for Disease Control and Prevention Jinan China.
3 Shenzhen Sun Yat-sen Cardiovascular Hospital Shenzhen China.
2 National Center for Chronic and Noncommunicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing China.


Background High sodium intake elevates blood pressure and thereby raises cardiovascular diseases ( CVD s). Sodium intake is high in northern China, including Shandong province where the SMASH (Shandong-Ministry of Health Action on Sodium and Hypertension) is currently underway. Methods and Results Blood pressure values and sodium intake measurements using 24-hour urinary excretion were collected from the 2011 SMASH baseline survey, which was conducted in 20 counties/districts using a multistage stratified cluster random sampling method. We derived cause-specific mortality from the Shandong Death Registration System ( SDRS ) during the same year and used population-attributable fraction to estimate annual CVD s deaths attributable to high sodium intake (mediated through elevated systolic blood pressure) and CVD deaths averted by achieving different sodium-reduction targets. Overall, 16 100 (95% uncertainty intervals, 11 000-22 600) CVD deaths among adults aged 25 to 69 years, including 5600 (4000-6500) for ischemic heart disease and 9000 (6700-11 600) for stroke, were attributable to higher sodium intake (2000 mg/day or 5.0 g/day of salt as a reference) in Shandong in 2011, accounting for 19.9% (13.7-25.0%) of total CVD deaths. The benefit of CVD deaths from sodium reduction is considerable with 8800 (6400-13 600), 6700 (4900-11 600), and 8500 (6000-10 800) averted, respectively, if sodium intake was reduced from the 2011 baseline to 3500 mg/day, 4000 mg/day, or reduced by 30%. Conclusions Nearly 20% of CVD deaths among adults aged 25 to 69 years could be attributable to the systolic blood pressure-raising effect of high sodium intake in Shandong in 2011. Potential benefits from population reduction of sodium intake are considerable.


blood pressure; cardiovascular disease prevention; population‐attributable fraction; salt intake; sodium

Free full text

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center