Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, January 26, 2017

Government-supported salt reduction strategy cost-effective worldwide

The unstated assumption here is that they are completely correct on salt reduction.  That is not completely supported. Maybe just like fat was the supposed killer 40 years ago. But what is your doctors' analysis? Not just parroting the anti-salt campaign, has s/he spent any time reading up on the relevant research?

Paper Raises More Questions About Salt Restriction In Heart Failure

 

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds.

 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease

The anti-salt here:

Government-supported salt reduction strategy cost-effective worldwide

A moderate government intervention strategy to reduce dietary sodium would be highly cost-effective worldwide, even without factoring potential health care savings, new data show.
“Excessive sodium consumption is common and linked to [CV] burdens in most countries,” Dariush Mozaffarian, MD, MPH, DrPH, dean of the Tufts Friedman School of Nutrition Science and Policy, and colleagues wrote. “Overall, 181 of 187 countries, representing 99.2% of the global adult population, have mean sodium intakes exceeding [WHO]-recommended maximum of 2 g [per] day.”
Mozaffarian and colleagues analyzed the cost-effectiveness of intervention strategies that sought to reduce national sodium intake by 10% over 10 years in 183 countries. They used data from 2010 to analyze sodium intake, BP levels and CVD rates.
Dariush Mozaffarian
Dariush Mozaffarian
Salt-reduction program
The interventions analyzed for the study were based off an existing program in the United Kingdom including government-supported industry agreements to reduce sodium in processed food, government compliance and a public health campaign. The U.K. intervention achieved a 14.7% reduction in population sodium intake over 10 years and a similar program in Turkey achieved a 16% reduction over 4 years, the researchers wrote.
Intervention costs were determined for individual countries using a WHO noncommunicable disease costing tool and then converted into international dollars (I$) for comparison.
Estimated health care savings were not evaluated to have a conservative cost-saving estimate.
Using country-specific data on population demographics, sodium consumption and rates of CVD, the researchers calculated the number of disability-adjusted life-years (DALYs) that would be averted by the interventions during a 10-year period.
Cost-effectiveness ratios were calculated by dividing total effect on DALYs by total cost of the intervention by country.
Overall, the global cost-effectiveness ratio of the 10-year intervention was about I$204 per DALY saved (95% uncertainty interval, 149-322). The researchers derived the figure from projected savings of 5.8 million DALYs per year related to CVD at a population-weighted mean cost of I$1.13 per capita over the 10 years.
The cost-effectiveness ratios were lower in lower middle income and upper middle income countries, higher in lower-income countries and highest in high-income countries, according to the researchers.
“Best buy”
“However you slice it, national salt reduction programs that combine industry targets and public education are a ‘best buy’ for governments and policymakers,” Mozaffarian said in a press release.
According to WHO benchmarks (a cost-effectiveness ratio < three times the gross domestic product per capita is cost-effective; a cost-effectiveness ratio < one time the GDP per capita is highly cost-effective), only one of the 183 countries did not meet the benchmark for cost-effectiveness (Marshall Islands, 4.7 times GDP per capita), and all but seven countries met the benchmark for high cost-effectiveness. Additionally, 96% of the world’s population (130 countries) had a cost-effectiveness ratio of < 0.1 time the GDP per capita.
“Our novel results, together with prior studies in selected countries, provide evidence that a national policy for reduction in sodium intake is highly cost-effective, and substantially more so than even highly cost-effective medical prevention strategies,” the researchers wrote. – by Cassie Homer

 

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