How public health can reduce premature deaths

Washington: To reduce the incidence of premature death from cardiovascular disease (CVD), people must maintain lower blood pressure, cut sodium intake, and eliminate trans fat from their diet, suggests a new study.

"Focusing our resources on the combination of these three interventions can have a huge potential impact on cardiovascular health through 2040," said lead author Goodarz Danaei in the study published in the Journal of Circulation.

Researchers estimated that scaling up treatment of high blood pressure to 70 per cent of the world's population could extend the lives of 39.4 million people. Cutting sodium intake by 30 per cent could stave off another 40 million deaths and could also help decrease high blood pressure, a major risk factor for CVD. And eliminating trans fat could prevent 14.8 million early deaths.

More than half of all delayed deaths, and two-thirds of deaths delayed before age 70 are projected to be among men, who have the highest numbers of non-communicable disease deaths globally, researchers found. Regions expected to benefit most from the interventions include East Asia, the Pacific and South Asia, as well as countries in sub-Saharan Africa.

The authors said that a variety of programmes and policies would be necessary to reduce premature CVD-related deaths. One important strategy would be to increase the use of blood pressure medications, many of which are safe and affordable.

The researchers acknowledged that scaling up the three interventions would be a huge challenge, requiring countries to commit additional resources to boost health care capacity and quality. But they added that previous analyses have shown that the interventions are achievable and affordable.

For example, a programme in Northern California increased control of hypertension to 90 per cent among thousands of the health system's patients between 2001 and 2013, using strategies such as improved treatment protocols, patient-friendly services and healthcare information systems that facilitate tracking people with hypertension.

Similar approaches have been adapted and tested in some low and middle-income countries, leading to notable improvements in hypertension treatment and control.