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Reducing dietary salt/sodium is one of the most cost-effective interventions to improve population health. There are five initiatives in the Americas that independently developed targets for reformulating foods to reduce salt/sodium content. Applying selection criteria, recommended by the Pan American Health Organization (PAHO)/World Health Organization (WHO) Technical Advisory Group on Dietary Salt/Sodium Reduction, a consortium of governments, civil society, and food companies (the Salt Smart Consortium) agreed to an inaugural set of regional maximum targets (upper limits) for salt/sodium levels for 11 food categories, to be achieved by December 2016. Ultimately, to substantively reduce dietary salt across whole populations, targets will be needed for the majority of processed and pre-prepared foods. Cardiovascular and hypertension organizations are encouraged to utilize the regional targets in advocacy and in monitoring and evaluation of progress by the food industry., (© 2015 Wiley Periodicals, Inc.)

Increased blood pressure is a leading risk for premature death and disability. The causes of increased blood pressure are intuitive and well known. However, the fundamental basis and means for improving blood pressure control are highly integrated into our complex societal structure both inside and outside our health system and hence require a comprehensive discussion of the pathway forward. A group of Canadian experts was appointed by Hypertension Canada with funding from Public Health Agency of Canada and the Heart and Stroke Foundation of Canada, Canadian Institute for Health Research (HSFC-CIHR) Chair in Hypertension Prevention and Control to draft a discussion Framework for prevention and control of hypertension. The report includes an environmental scan of past and current activities, proposals for key indicators, and targets to be achieved by 2020, and what changes are likely to be required in Canada to achieve the proposed targets. The key targets are to reduce the prevalence of hypertension to 13% of adults and improve control to 78% of those with hypertension. Broad changes in government policy, research, and health services delivery are required for these changes to occur. The Hypertension Framework process is designed to have 3 phases. The first includes the experts' report which is summarized in this report. The second phase is to gather input and priorities for action from individuals and organizations for revision of the Framework. It is hoped the Framework will stimulate discussion and input for its full intended lifespan 2011-2020. The third phase is to work with individuals and organizations on the priorities set in phase 2., (Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

A chronic disease/risk factor prevention framework with three policy environments--communications, physical and economic--was used to organize population level interventions that address the "over consumption of dietary salt", a key risk factor for cardiovascular diseases. The framework was then used to map the population based strategies to reduce dietary salt consumption being applied in three countries in the Americas--Argentina, Canada and Chile--each with a history of multi-sector approaches to deal with the risk factors for chronic disease, offering a north versus south perspective. Results show that in all three countries policy instruments are concentrated in the communications environment, e.g., media and education campaigns and/or regulations for standardized information on the salt or sodium content of packaged food products. Notable gaps are the requirement for nutrient information on meals and food items prepared by food establishments and restrictions on advertising and marketing of foods to children. In the physical environment, referring to the sodium levels in commercially prepared foods and meals available on the market, voluntary reformulation of food products is underway at this time in the three countries. Argentina and Chile began with bread and have gradually added other food categories; Canada at the outset is addressing all food categories where products have added salt. Argentina alone is at this point actively approaching regulations to limit the salt content of food, preferring this over ongoing monitoring of voluntary targets. No government in the three counties has yet considered action in the economic environment, a complex area where the research on and initiatives to limit or disadvantage energy-dense food products to address obesity may also capture foods that are highly salted. In the meantime, with recent research estimating substantially higher gains in population health from government legislation to limit salt in foods compared to voluntary approaches, decision makers in countries, whether in the north or south, committed to reducing dietary salt can take Argentina's example to strengthen their interventions in the physical environment with regulatory instruments. This will sustain reformulations made to date, "level the playing field" industry-wide and broadly and equitably distribute the health benefits of low salt foods., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)