Evidence map›Paper›PMID 39465247›Full record

ArticleHypertension (Dallas, Tex. : 1979)2024

Cost-Effectiveness of Salt Substitution and Antihypertensive Drug Treatment in Chinese Prehypertensive Adults.

Zhijia Sun, Haijun Zhang, Yinqi Ding, Canqing Yu, Dianjianyi Sun, Yuanjie Pang, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Ambient PMEnvironment & health (Washington, D.C.) · 2026
    Article
  2. New evidence linking lifestyle factors to blood pressure: Focus on 2024 findings.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Zhijia Sun *Department of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0009-0008-8590-6659
Haijun Zhang *Department of Health Policy and Management (H.Z.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0001-9321-6924
Yinqi DingDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.
Canqing YuDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0002-0019-0014
Dianjianyi SunDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0003-3651-6693
Yuanjie PangDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0002-4826-8861
Pei PeiPeking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China (C.Y., D.S., Y.P., P.P., L.L., J.L.).
Ling YangClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., H.D., D.A., Z.C.).ORCID 0000-0001-5750-6588
Yiping ChenClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., H.D., D.A., Z.C.).ORCID 0000-0002-4973-0296
Huaidong DuClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., H.D., D.A., Z.C.).ORCID 0000-0002-9814-0049
Weijie HuMaiji Center for Disease Control and Prevention, Gansu, China (W.H.).
Daniel AveryClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., H.D., D.A., Z.C.).ORCID 0000-0002-9823-9575
Junshi ChenChina National Center for Food Safety Risk Assessment, Beijing, China (J.C.).
Zhengming ChenClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (L.Y., Y.C., H.D., D.A., Z.C.).ORCID 0000-0001-6423-105X
Liming LiDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0001-5873-7089
Jun LvDepartment of Epidemiology and Biostatistics (Z.S., Y.D., C.Y., D.S., Y.P., L.L., J.L.), School of Public Health, Peking University, Beijing, China.ORCID 0000-0002-3559-0640
China Kadoorie Biobank Collaborative Group†

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent guidelines recommend antihypertensive drug treatment for prehypertensive individuals with blood pressure between 130/80 and 139/89 mm Hg. This study evaluates the cost-effectiveness of 3 interventions in Chinese prehypertensive adults: salt substitution, antihypertensive drug treatment, and their combination.

methodsWe developed a Markov cohort model to estimate cardiovascular disease (CVD) events, costs, and quality-adjusted life years (QALYs) over a lifetime. Data from the China Kadoorie Biobank informed the simulation. Costs and utilities were drawn from published sources. We evaluated the cost-effectiveness of salt substitution alone, antihypertensive drug treatment alone, and a combination of the 2, focusing on the overall prehypertensive population, those at high CVD risk, and different starting ages (40, 50, 60, and 70 years). Incremental cost-effectiveness ratios (ICERs) were calculated per QALY gained.

resultsSalt substitution at age 40 years is the only cost-effective strategy for prehypertensive individuals, with an ICER of $6413.62/QALY. For those at high CVD risk, the combination intervention starting at age 40 years is most cost-effective, with an ICER of $2913.30/QALY. Interventions initiated at younger ages yielded greater CVD reductions and lower ICERs. For example, a combined intervention at age 40 years reduces CVD events by 5.3% with an ICER of $2913.30/QALY, compared with 4.9% and $32 635.33/QALY at age 70 years. These results were consistent across sensitivity analyses.

conclusionsIn China, replacing usual salt with a salt substitute is more cost-effective than treating prehypertensive individuals over the age of 40 years with antihypertensive drugs. Furthermore, starting intervention at a younger age in prehypertensive adults can result in even greater cost savings.

Indexed as

Antihypertensive AgentsCost-Benefit AnalysisPrehypertensionQuality-Adjusted Life YearsAdultAgedBlood PressureChinaEast Asian PeopleFemaleHumansHypertensionMaleMarkov ChainsMiddle AgedSodium Chloride, DietaryAntihypertensive AgentsSodium Chloride, Dietaryantihypertensive agentsChinesecost-effectiveness analysisprehypertensionsalt

Identifiers

PMID39465247
PMCPMC11578052

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.