Table 2.

Cost-effectiveness of interventions in developed countries to reduce sodium intake

1st author, year/analysis type/country	Populations /interventions	Study design and methods	Main results
Smith-Spangler 2010/cost-effectiveness/US	Adults aged 40–85 years/population-based: government collaboration with food industry versus sodium tax	Markov model constructed with four health states: well, AMI, acute stroke, history of AMI or stroke	Government collaboration with food manufacturers is more effective than a tax on sodium, although both programs would improve health and save billions of dollars.
Bibbins-Domingo 2010/cost-effectiveness/US	US residents aged 35 years of age or older/population-based program	Markov modeling (computer simulation, state-transition model)	Reduction in salt intake of 3 g/day saves US$10 to $24 billion in annual medical costs. It would be more cost-effective than using drugs to control hypertension for everyone with that disorder.
Palar 2009/medical cost savings, QALYs gained/US	Noninstitutionalized US adults aged 18 and older/population-based program	Cross-sectional simulation/health outcomes: cases of hypertension and QALYs	Reducing sodium intake to 2300 mg/day may result in 11 million fewer cases of hypertension, reduce medical costs by US$18 billion, and gain 312 000 QALYs (valued at US$32 billion) annually.
Dall 2009/savings in medical costs/US	225 million adults aged 18 and older/population-based program	Simulation model/hypothetical dietary change	Reduction in sodium intake of 400 mg/day in hypertensive persons would result in 1.5 million fewer cases annually, saving US$2.3 billion.
Dall 2009/national productivity gain/US	225 million adults aged 18 and older/population-based program	Simulation model/hypothetical dietary change	Reductions in sodium intake of 400 mg/day in hypertensive persons would increase annual productivity by US$ 2.5 billion.
Joffres 2007/medical costs savings/Canada	23 129 individuals from the Canadian Heart Health Surveys/population-based program	Obtaining information from various data sources. No specific cost-effectiveness methods used	Sodium reduction reduced prevalence of hypertension and saved substantial medical costs (US$430 million in direct costs; physician visits and laboratory costs decreased by 6.5%).
Kristiansen 2006/willingness to pay/Denmark	Random sample of Danish adults (n = 924) aged 20–74 years/population-based program	Contingent valuation through computer-assisted personal interviewing	The annual net program cost was US$148 million, less than the aggregate willingness to pay of US$ 468 million. The program is economically justifiable.
Selmer 2000/cost of interventions versus medical cost savings/Norway	Aged 40 and older/population-based program	Dynamic simulation model	The costs of the population interventions will be offset by cost savings from fewer strokes and heart attacks.

AMI, acute myocardial infarction; CVD, cardiovascular disease; QALY, quality-adjusted life-year.