Salt substitute confers better stroke outcomes at lower cost vs. regular salt
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WASHINGTON — Compared with regular salt intake, using a salt substitute was associated with better outcomes at lower cost for stroke prevention and quality-adjusted life-years gained, according to new data from the SSaSS trial.
The results were presented at the American College of Cardiology Scientific Session and simultaneously published in Circulation.
As Healio previously reported, in the main results of Salt Substitute and Stroke Study (SSaSS), the rate of stroke was 14% lower with a salt substitute in a cohort of 20,995 adults living in rural China who had prior stroke or uncontrolled high BP (rate ratio = 0.86; 95% CI, 0.77-0.96; P = .006).
“The findings motivated us to gauge whether salt substitute also represents good value for money by considering both the costs and health-related outcomes,” Lei Si, PhD, senior research fellow in health economics at The George Institute for Global Health in Newtown, New South Wales, Australia, conjoint senior lecturer at the University of New South Wales, Sydney, and associate editor of health economics for BMJ Global Health, told Healio.
For the present analysis, the researchers conducted an economic evaluation on the effects of stroke prevention and QALYs. They used bivariate multilevel models to estimate incremental costs measured in Chinese yuan, stroke events avoided and QALYs gained.
During a mean of 4.7 years of follow-up, the salt substitute group averaged 0.054 QALYs more than the control group, according to the researchers.
Average costs were 1,538 Chinese yuan in the salt substitute group and 1,649 Chinese yuan in the control group, for a difference of 110 Chinese yuan favoring the salt substitute group, Tian and colleagues found.
The researchers concluded that the salt substitute was economically dominant, conferring better outcomes at lower cost, for stroke prevention and QALYs gained, and that it had a 95% probability of being cost-saving and a 99.9% probability of being cost-effective.
“Despite additional research being needed to prove if reduced-sodium salt substitute will remain cost saving in other countries, the salt substitute will represent good value for money in many countries where dietary sodium mainly derives from ‘discretionary salt’,” Si told Healio.
In sensitivity analyses, the only scenario in which the salt-substitute intervention was not economically dominant was if its price was increased to the median market price or the highest market price in China.
“These findings will support countries planning or implementing salt reduction campaigns to consider salt substitute intervention as an essential component,” Si told Healio. “For example, China has launched the Healthy China 2030 action plan in 2019, one of the key actions of which is to reduce mortality due to cardiovascular diseases. This study provides direct and the first evidence that salt substitute should be considered as a priority for this national health campaign.”
Reference:
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Yin X, et al. Abstract 1056-03. Presented at: American College of Cardiology Scientific Session; April 2-4, 2022; Washington, D.C. (hybrid meeting).
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