3 interventions could prevent 94M early deaths by 2040

Harvard researchers have identified three health interventions that, if implemented and followed closely over the next quarter-century, could prevent up to 94 million early deaths from noncommunicable diseases (NCDs) like CVD.

First author Vasilis Kontis, PhD, and colleagues said in their paper that NCDs account for 38 million deaths each year, and a good fraction of those fatalities are linked to circulatory and cardiovascular health. High blood pressure alone accounted for 16 million premature NCD deaths in 2016, making it the leading risk factor for chronic diseases like cancer, diabetes and stroke.

“Three specific interventions have a potential to save lives on a large scale: treating high blood pressure, reducing dietary sodium intake and eliminating artificial trans fat intake,” Kontis and co-authors wrote in Circulation, where they published their findings June 10. “However, there has been limited progress addressing them, despite the fact that there are cost-effective and feasible interventions with substantial impact on preventing NCDs worldwide.”

Kontis et al. extracted global data on mean blood pressure levels and sodium and trans fat intake from a pooled analysis of population health surveys, regional estimates and cause-specific mortality statistics, separating data points by country, age and sex. They estimated the proportional effect of each intervention on reducing mortality from related causes.

The researchers found that scaling up the treatment of high blood pressure to 70% of the world’s population would extend 39.4 million people’s lives, and eliminating trans fats entirely could prevent 14.8 million early deaths. If the global population were to cut their collective sodium intake by around 30%, that would save an additional 40 million lives.

Kontis and colleagues said individuals in East Asia, the Pacific, South Asia and countries in sub-Saharan Africa will likely benefit the most from these three interventions, though it will take a significant effort to implement them anywhere. While all three factors have “enormous potential to save lives,” the authors also acknowledged it would be a “huge challenge” to meet these goals.

The only way we can actually prevent 94 million deaths is if countries step up and allocate more resources to healthcare, the authors wrote. Previous cost-effective analyses of all three interventions show they’re both achievable and affordable—reducing sodium intake by 15% is estimated to cost less than $0.40 per person per year in low-income countries, and scaling up a more comprehensive drug regimen for CVD reduction would cost around $1.10 per person per year.

“Successful global implementation would require increased investment in healthcare capacity and quality of care in the primary healthcare sector, and increased efforts to reduce sodium and eliminate trans fat intake through regulation and health promotion campaigns, as well,” Kontis et al. said. “If countries commit resources to implement these highly cost-effective interventions, they will save lives and help achieve the targets set in the sustainable development goals to reduce premature NCD deaths.”