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Impact of salt intake reduction on CVD mortality in Costa Rica: A scenario modelling study.

ABSTRACT: Cardiovascular diseases (CVD) represent the leading cause of death in Costa Rica and high blood pressure was associated with a mortality rate of 29% in 2018. The average household sodium intake in the country is also two times higher than the World Health Organization recommendation. The objective of this study was to estimate the impact of reducing salt intake on CVD mortality in Costa Rica using a scenario simulation model. The Preventable Risk Integrated ModEl (PRIME) was used to estimate the number of deaths that would be averted or delayed in the Costa Rican population by following the national and the international guidelines to reduce salt consumption, according to two scenarios: A) 46% reduction and B) 15% reduction, both at an energy intake of 2171 kcal. The scenarios estimated that between 4% and 13%, respectively, of deaths due to CVD would be prevented or postponed. The highest percentages of deaths prevented or postponed by type of CVD would be related to Coronary heart disease (39% and 38%, respectively), Hypertensive disease (32% and 33%, respectively), and Stroke (22% in both). The results demonstrate that reducing salt consumption could prevent or postpone an important number of deaths in Costa Rica. More support for existing policies and programs urges.

SUBMITTER: Vega-Solano J

PROVIDER: S-EPMC7802917 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Impact of salt intake reduction on CVD mortality in Costa Rica: A scenario modelling study.

Vega-Solano Jaritza J Blanco-Metzler Adriana A Madriz-Morales Karol K Fernandes-Nilson Eduardo-Augusto EA Labonté Marie Eve ME

PloS one 20210112 1

Cardiovascular diseases (CVD) represent the leading cause of death in Costa Rica and high blood pressure was associated with a mortality rate of 29% in 2018. The average household sodium intake in the country is also two times higher than the World Health Organization recommendation. The objective of this study was to estimate the impact of reducing salt intake on CVD mortality in Costa Rica using a scenario simulation model. The Preventable Risk Integrated ModEl (PRIME) was used to estimate the ...[more]

PMID: 33434241

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Project description:Rationale: MicroRNAs have emerged as crucial post-transcriptional and network regulators in inflammatory diseases, including asthma. We hypothesized that peripheral blood miRNA would be associated with airflow obstruction in children with asthma, and that some of these effects would also be observable in adults with COPD. Methods: We analyzed small RNA-Seq data from 365 peripheral blood samples from the Genetics of Asthma in Costa Rica Study (GACRS). GACRS comprised children from the Central Valley of Costa Rica age 6-14 years with physician-diagnosed asthma and ≥2 respiratory symptoms or asthma attacks in the prior year. FEV1/FVC percent-predicted was dichotomized at 100%, splitting the cohort into those with and without evidence of airflow obstruction and used as our primary outcome. Differentially expressed (DE) miRs were identified using the DESeq2 package in R with a 10% FDR and adjustment for age, gender, and inhaled corticosteroid (ICS) use. We attempted to replicate the top airflow obstruction-associated microRNAs from the GACRS study in the COPDGene study, in which blood microRNA data were available in 439 current and former smoking adults with and without airflow obstruction (defined as raw FEV1/FVC < 0.7). Results: After QC, we had 361 samples and 649 miRs for DE analysis. Of the 361 samples, 220 and 141 were from subjects without and with airflow obstruction, respectively. We found 1 upregulated (let-7e-5p p=0.0004) and 2 downregulated (miR-342-3p p=0.0002; miR-671-5p p=0.0001) miRs in subjects with airflow obstruction compared to those without airflow obstruction. These three miRNAs were then tested for association with airflow obstruction in the COPDGene study, in which let-7e-5p was upregulated (p = 0.064) and miR-342-3p (p =0.085) was downregulated in participants with FEV1/FVC < 0.7 (n=196) compared to those with FEV1/FVC > 0.7 (n=243). Differentially expressed miR’s target genes were enriched for PI3K-Akt, Hippo, WNT, MAPK, and focal adhesion signaling pathways. We also separately considered the targets of only the two miRNAs that were also associated with FEV1/FVC in the adult current and former smokers, where PI3K-Akt, MAPK and Hippo signaling pathways were among the top five most enriched pathways. Conclusion: Three DE miRs were linked to airflow obstruction in children with asthma. Two miRs were associated with FEV1/FVC in current and former smoking adults. These miRs were involved in asthma and COPD-related pathways: PI3K-Akt, Hippo, MAPK, and focal adhesion signaling pathways. Together these findings provide important evidence that these two disorders may share genetic regulatory systems that contribute to airflow obstruction.

Dataset Information

Impact of salt intake reduction on CVD mortality in Costa Rica: A scenario modelling study.

Publications

Impact of salt intake reduction on CVD mortality in Costa Rica: A scenario modelling study.

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