Global Disease Burden Estimates of Cardiovascular Diseases attributable to High Sodium Intake, 1990-2021

Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with high sodium intake (HSI) being a key modifiable risk. Despite WHO recommendations (<2 g/day sodium), global consumption remains excessive. This study assesses spatiotemporal trends and socioeconomic determinants of HSI-attributable CVD burden from 1990 to 2021. Using Global Burden of Disease (GBD) Study 2021 data, we analyzed HSI-related CVD mortality and disability-adjusted life years (DALYs). Trends were quantified using Joinpoint regression and estimated annual percentage change (EAPC). Sociodemographic Index (SDI) correlations and age-period-cohort (APC) models were assessed. Globally, HSI-attributable CVD DALYs increased by 40.88% (1990: 26.8 million; 2021: 37.7 million), while age-standardized mortality (ASMR) and DALY (ASDR) rates declined 34.8% and 36.1%, respectively. Middle-SDI regions carried the highest burden (ASMR: 47.95/100,000; ASDR: 28.7/100,000). SDI showed an inverse correlation with HSI-related CVD burden ( P <0.001), with high-SDI regions exhibiting the steepest ASMR decline (EAPC = −2.51) APC models confirmed reduced risk over time, and males consistently exhibited higher burdens than females. While age-standardized rates declined, absolute HSI-related CVD burden rose, emphasizing the need for targeted sodium reduction. Middle- and low-SDI regions require prioritized interventions, including food policy reforms and gender-specific strategies. High-SDI success models demonstrate multisectoral approaches are effective. Accelerated global collaboration is critical to meet WHO 2025 targets and address disparities linked to socioeconomic development and aging.