More heart disease + better treatment = higher costs

An aging population that includes too many people who are obese or overweight will drive up the costs associated with heart disease substantially by 2030, says a study in Health Affairs. One of the problems is that the health care system will be victim to the success of treatments that will keep heart disease patients alive longer. Society should focus more on prevention, the researchers argue.

“The question of whether to make treatment or prevention of cardiovascular disease a higher priority had often been debated, and most researchers have suggested balanced approaches,” they write in “More Americans Living Longer With Cardiovascular Disease Will Increase Costs While Lowering Quality of Life,” in the October issue of Health Affairs. “However, our findings suggest that substantial reductions in incidence are crucial: Otherwise, improvements in mortality from cardiovascular disease (along with aging and obesity trends) will lead to a troubling increase in prevalence.”

The average 10-year risk of heart disease will rise to about 15% for men and 9% for women by 2030, from a baseline of 12.7% and 6.8% in 1991, the study states. Researchers used data from the National Health and Nutrition Examination Surveys to make their forecast.

In addition, they relied on meta-analyses of cholesterol and blood pressure treatment. “Physical activity was not included as a risk factor because a high proportion of relevant data was missing and definitions of physical activity changed....”

The authors add that “improvements in treatment of cardiovascular disease and smoking rates have not outweighed (and will not outweigh) the influence that rising age and obesity have had on increasing total risk of cardiovascular disease.”

Disturbing forecast

Prevalence of cardiovascular disease in the United States for men and women ages 25–85, selected years 2000–10 and 2015–30

Linear trend lines added for trend analysis (solid lines) and projections (dotted lines). Lighter shaded points for years 2015–30 are projections.

SOURCE: “More Americans Living Longer With Cardiovascular Disease Will Increase Costs While Lowering Quality of Life,” Health Affairs, October 2013.

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