National and Subnational Cardiovascular Diseases Mortality Attributable to Salt Consumption in Iran by Sex and Age From 1990 to 2016

Background: Dietary salt consumption is an important factor for mortality from cardiovascular diseases (CVDs). Therefore, the aim of this study is to measure the levels of salt consumption and then estimate the effects of current levels of salt consumption on mortality from CVDs at national and subnational levels from 1990 to 2016 in Iran.

Methods: In this study, we will use national and subnational studies with data on salt consumption, including self-report or lab tests for sodium measurement and all available published data about salt and sodium (with conduct a systematic review) to estimate salt exposure levels. We will also use data from death registration system (DRS) to estimate CVDs mortality attributable to salt consumption. We will use mixed-effects model to explore the effects of some covariates on salt consumption and then spatial-temporal model will be used to take into account how the values of salt consumption in each point vary further across time, space, and age. We will compute the proportional reduction in CVD deaths that will occur if salt consumption reduces to an alternative level (5 g/d), using comparative risk assessment (CRA). The simulation analysis will be used to estimate the uncertainty of the number of deaths attributable to salt consumption. All analyses will be performed separately by sex and age groups, province and year in STATA and R software packages.

Conclusion: The findings of this study seem to be helpful for providing good information about the salt consumption and CVDs mortality attributable to it for policymakers in directing future policy decisions and planning cost-effective strategies in Iran.