Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Schmidt SM[original query] |
---|
Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches
Coxson PG , Cook NR , Joffres M , Hong Y , Orenstein D , Schmidt SM , Bibbins-Domingo K . Hypertension 2013 61 (3) 564-70 Computer simulations have been used to estimate the mortality benefits from population-wide reductions in dietary sodium, although comparisons of these estimates have not been rigorously evaluated. We used 3 different approaches to model the effect of sodium reduction in the US population over the next 10 years, incorporating evidence for direct effects on cardiovascular disease mortality (method 1), indirect effects mediated by blood pressure changes as observed in randomized controlled trials of antihypertension medications (method 2), or epidemiological studies (method 3). The 3 different modeling approaches were used to model the same scenarios: scenario A, gradual uniform reduction totaling 40% over 10 years; scenario B, instantaneous 40% reduction in sodium consumption sustained for 10 years to achieve a population-wide mean of 2200 mg/d; and scenario C, instantaneous reduction to 1500 mg sodium per day sustained for 10 years. All 3 methods consistently show a substantial health benefit for reductions in dietary sodium under each of the 3 scenarios tested. A gradual reduction in dietary sodium over the next decade (scenario A) as might be achieved with a range of proposed public health interventions would yield considerable health benefits over the next decade, with mean effects across the 3 models ranging from 280,000 to 500,000 deaths averted. Projections of instantaneous reductions illustrate the maximum benefits that could be achieved (0.7-1.2 million deaths averted in 10 years). Under 3 different modeling assumptions, the projected health benefits from reductions in dietary sodium are substantial. |
Lifestyle interventions for hypertension and dyslipidemia among women of reproductive age
Robbins CL , Dietz PM , Bombard J , Tregear M , Schmidt SM , Tregear SJ . Prev Chronic Dis 2011 8 (6) A123 INTRODUCTION: Hypertension and dyslipidemia often precede cardiovascular disease. Lifestyle modifications help prevent these conditions, and referrals for women may be possible during reproductive health care visits. However, screening recommendations vary, which may affect screening rates. The objectives of this systematic review were to 1) assess the available literature on the effectiveness of lifestyle interventions, 2) review hypertension and dyslipidemia screening recommendations for consistency, and 3) report prevalence data for hypertension and dyslipidemia screening among women of reproductive age. METHODS: We conducted a systematic literature search (January 1990-November 2010) for 1) randomized controlled trials on the impact of lifestyle interventions on cardiovascular disease risk factors in women of reproductive age, 2) evidence-based guidelines on hypertension and dyslipidemia screening, and 3) population-based prevalence studies on hypertension or dyslipidemia screening or both. RESULTS: Twenty-one of 555 retrieved studies (4%) met our inclusion criteria. Lifestyle interventions improved lipid levels in 10 of 18 studies and blood pressure in 4 of 9 studies. Most guidelines recommended hypertension screening at least every 2 years and dyslipidemia screening every 5 years, but recommendations for who should receive dyslipidemia screening varied. One study indicated that 82% of women of reproductive age received hypertension screening during the preceding year. In another study, only 49% of women aged 20 to 45 years received recommended dyslipidemia screening. CONCLUSION: Lifestyle interventions may offer modest benefits for reducing blood pressure and lipids in this population. Inconsistency among recommendations for dyslipidemia screening may contribute to low screening rates. Future studies should clarify predictors of and barriers to cholesterol screening in this population. |
Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the County of Los Angeles
Gase LN , Kuo T , Dunet D , Schmidt SM , Simon PA , Fielding JE . Am J Public Health 2011 101 (8) 1501-7 OBJECTIVES: We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. METHODS: We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. RESULTS: Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs. CONCLUSIONS: Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow. (Am J Public Health. Published online ahead of print June 16, 2011: e1-e7. doi:10.2105/AJPH.2011.300138). |
Proceedings from the workshop on estimating the contributions of sodium reduction to preventable death
Schmidt SM , Andrews T , Bibbins-Domingo K , Burt V , Cook NR , Ezzati M , Geleijnse JM , Homer J , Joffres M , Keenan NL , Labarthe DR , Law M , Loria CM , Orenstein D , Schooley MW , Sukumar S , Hong Y . CVD Prev Control 2011 6 (2) 35-40 The primary goal of this workshop was to identify the most appropriate method to estimate the potential effect of reduction in sodium consumption on mortality. Difficulty controlling hypertension at the individual level has motivated international, federal, state, and local efforts to identify and implement population-wide strategies to better control this problem; reduction of sodium intake is one such strategy. Published estimates of the impact of sodium consumption on mortality have used different modeling approaches, effect sizes, and levels of sodium consumption, and thus their estimates of preventable deaths averted vary widely, and are not comparable. In response to this problem, the Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention (DHDSP) convened and facilitated a workshop to examine different methods of estimating the effect of sodium reduction on mortality. The panelists agreed that any of the methodologies presented could provide reasonable estimates, and therefore discussion focused on challenges faced by all methods. The panel concluded that future sodium modeling efforts should generate multiple estimates employing the same scenarios and effect sizes while using different modeling techniques; in addition, future efforts should include outcomes other than mortality (morbidity, costs, and quality of life). Varying reductions in sodium should be modeled at the population level over different time intervals. In an effort to better address some of the uncertainties highlighted by this workshop, the panelists are currently considering developing multiple estimates in a collaborative manner to clarify the potential impact of population-based interventions to reduce sodium consumption. |
Clinical preventive services for patients at risk for cardiovascular disease, National Ambulatory Medical Care Survey, 2005-2006
Yoon PW , Tong X , Schmidt SM , Matson-Koffman D . Prev Chronic Dis 2011 8 (2) A43 INTRODUCTION: Clinical preventive services can detect diseases early, when they are most treatable, but these services may not be provided as recommended. Assessing the provision of services to patients at risk for cardiovascular disease (CVD) could help identify disparities and areas for improvement. METHODS: We used data on patient visits (n = 21,261) from the National Ambulatory Medical Care Survey, 2005-2006, and classified patients with hypertension, hyperlipidemia, obesity, or diabetes as being at risk for CVD. We assessed differences in the provision of preventive services offered to patients who were and who were not at risk for CVD. Further, for those at risk, we compared the demographic characteristics of those who had and who had not been offered services. RESULTS: Patients at risk for CVD received significantly more preventive services compared with those not at risk. For patients at risk for CVD, aspirin therapy was more likely to be recommended to those aged 65 years or older than those aged 45 to 64 years and to men than women. Cholesterol screening was more likely for men and was less likely for patients with Medicare/Medicaid or no insurance than for patients who were insured. Rates of counseling for diet and nutrition, weight reduction, and exercise were low overall, but younger patients received these services more than older patients did. CONCLUSION: Patients at risk for CVD are not all receiving the same level of preventive care, suggesting the need to clarify clinical practice guidelines and provide clinicians with education and support for more effective lifestyle counseling. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 13, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure