THE GLOBAL BURDEN AND TEMPORAL TRENDS IN MORTALITY OF HYPERTENSIVE HEART DISEASE ATTRIBUTABLE TO HIGH SODIUM INTAKE,1990 TO 2021: AN AGE-PERIOD-COHORT ANALYSIS

Objective: High sodium intake is associated with increased blood pressure. Hypertensive heart disease (HHD) is a structural and functional alteration of the left ventricle caused by long-term high blood pressure, which is closely related to many adverse events. We report an overview of trends in mortality of HHD attributable to high sodium intake over the past 30 years and associations with age, period, and birth cohort.Design and method: We extracted detailed data from the Global Burden of Disease (GBD) 2021 study on HHD attributable to a high-sodium diet worldwide from 1990 to 2021. We used an age-period-cohort model to estimate the overall annual percentage change in mortality, annual percentage change from 25 to 89 years, period and cohort effects between 1990 and 2021. Results: In 2021, the number of HHD deaths attributable to high sodium intake was 303,967 (95% CI: 641,085 to 63,832). Annual percentage changes indicated a general decline in mortality of HHD attributable to high sodium intake in all age groups globally. The steepest decline in mortality was in the 55-59 age group (-2.59% per year, 95% CI -2.79%, -2.38%). A less favorable trend was observed in both young and old people [25-29 years: (-1.18%, 95% CI -2.75%, 0.42%),85-89 years: -0.56%, 95% CI (-0.74%, -0.38%)]. Males showed significantly slower mortality reductions than females in age groups. The age-period-cohort analysis demonstrated that the global risk of mortality of HHD attributable to high sodium intake increased with age. The period effect was characterized by a decline followed by a leveling off. Globally, there was an overall decline in risk for the birth cohort. In contrast, the risk of death has continued to rise over the past decade in high socio-demographic index (SDI) countries. High SDI countries are at risk of unfavorable or worsening risks in the near term and the birth cohort. Conclusions: Our findings examined and distinguished the age, period, and cohort effects in mortality trends. It is vital to identify differences and treatment gaps in lifestyle management and cardiac care across populations and regions.