The Impact of Prevention on Reducing the Burden of Cardiovascular Disease

نویسندگان

  • Richard Kahn
  • Rose Marie Robertson
  • Robert Smith
  • David Eddy
چکیده

OBJECTIVE Cardiovascular disease (CVD) is prevalent and expensive. While many interventions are recommended to prevent CVD, the potential effects of a comprehensive set of prevention activities on CVD morbidity, mortality, and costs have never been evaluated. We therefore determined the effects of 11 nationally recommended prevention activities on CVD-related morbidity, mortality, and costs in the U.S. RESEARCH DESIGN AND METHODS We used person-specific data from a representative sample of the U.S. population (National Health and Nutrition Education Survey IV) to determine the number and characteristics of adults aged 20-80 years in the U.S. today who are candidates for different prevention activities related to CVD. We used the Archimedes model to create a simulated population that matched the real U.S. population, person by person. We then used the model to simulate a series of clinical trials that examined the effects over the next 30 years of applying each prevention activity one by one, or altogether, to those who are candidates for the various activities and compared the health outcomes, quality of life, and direct medical costs to current levels of prevention and care. We did this under two sets of assumptions about performance and compliance: 100% success for each activity and lower levels of success considered aggressive but still feasible. RESULTS Approximately 78% of adults aged 20-80 years alive today in the U.S. are candidates for at least one prevention activity. If everyone received the activities for which they are eligible, myocardial infarctions and strokes would be reduced by approximately 63% and 31%, respectively. If more feasible levels of performance are assumed, myocardial infarctions and strokes would be reduced approximately 36% and 20%, respectively. Implementation of all prevention activities would add approximately 221 million life-years and 244 million quality-adjusted life-years to the U.S. adult population over the coming 30 years, or an average of 1.3 years of life expectancy for all adults. Of the specific prevention activities, the greatest benefits to the U.S. population come from providing aspirin to high-risk individuals, controlling pre-diabetes, weight reduction in obese individuals, lowering blood pressure in people with diabetes, and lowering LDL cholesterol in people with existing coronary artery disease (CAD). As currently delivered and at current prices, most prevention activities are expensive when considering direct medical costs; smoking cessation is the only prevention strategy that is cost-saving over 30 years. CONCLUSIONS Aggressive application of nationally recommended prevention activities could prevent a high proportion of the CAD events and strokes that are otherwise expected to occur in adults in the U.S. today. However, as they are currently delivered, most of the prevention activities will substantially increase costs. If preventive strategies are to achieve their full potential, ways must be found to reduce the costs and deliver prevention activities more efficiently.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

برآورد سهم چاقی مرکزی بر بار بیماری‌های قلبی عروقی در استان آذربایجان غربی

    Background & Aims : Cardiovascular diseases are the most common cause of death in West Azerbaijan province. This study was conducted to estimate the contribution to the burden of modification risk factor of central obesity and determine the effect of reducing its prevalence on cardiovascular diseases in this province.   Materials & Methods : To calculate the P otential Impact Fraction...

متن کامل

“Big” Food, Tobacco, and Alcohol: Reducing Industry Influence on Noncommunicable Disease Prevention Laws and Policies; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”

The food, tobacco and alcohol industries have penetrated markets in low- and middle-income countries (LMICs), with a significant impact on these countries’ burden of noncommunicable diseases (NCDs). Tangcharoensathien and colleagues describe the aggressive marketing of unhealthy food, alcohol and tobacco in LMICs, as well as key tactics used by these industries to resis...

متن کامل

سهم تأثیر بالقوه برخی عوامل خطر تعدیل‌پذیر در بار بیماری‌های قلبی- عروقی در ایران: ارزیابی خطر مقایسه‌ای

 Background: Increasing the prevalence of risk factors of cardiovascular diseases, emphasizes on health policy, priority setting and preventing cardiovascular diseases deaths. This study aimed to assess Potential Impact Fraction of modifying selected risk factors on burden of cardiovascular disease in Iran. Methods: To calculate Potential Impact Fraction (PIF) of risk factors WHO compa...

متن کامل

Estimation of the Economic Burden of Cardiovascular Diseases in selected Hospital of Mashhad in 2020 Javadalameh Heart Hospital)

In Iran, cardiovascular diseases rank first in terms of mortality. Cardiovascular disease leads families to fall into the abyss of poverty and worsens the disease. Health policy makers need to be aware of the costs of these diseases in order to make decisions about the optimal allocation of resources. The aim of this study was to estimate the economic burden of cardiovascular diseases in select...

متن کامل

O3: Anxiety Psychopathology - Epidemiology and Burden of Disease: Problems and Solutions

The goal of this talk will be to familiarize the audience with the nature and prevalence of anxiety disorders and document their impact on society. Anxiety is the most common form of psychopathology affecting an estimated one in four people at some point during their lifetimes. In comparison to all types of diseases and injuries, a 2013 JAMA report indicated that anxiety disorders were the fift...

متن کامل

تاثیر آموزش معلمان بر ارتقاء دانش، نگرش و عملکرد دانش آموزان در پیشگیری از بیماریهای قلبی عروقی:کاربرد مدلHBM

Abstract Introduction: Cardiovascular diseases are the leading cause of morbidity, mortality and disability around the world. Education based on training models such as the health belief model is one of the most basic methods of prevention of diseases. The present study was conducted to determine the impact of teacher education based on the HBM model on promoting knowledge, attitude and perf...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Diabetes Care

دوره 31  شماره 

صفحات  -

تاریخ انتشار 2008