Circ: Costs to treat heart disease will triple to $818B by 2030

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By 2030, the cost to treat heart disease will triple, and rise from $273 billion to $818 billion in the U.S. A bigger push to find effective prevention strategies is necessary to limit the burden of cardiovascular disease, according to a policy statement published Jan. 25 in Circulation.

The American Heart Association (AHA) expert panel, which put forth the statement, estimated the future medical costs of heart disease based on the current rates of disease and Census data to adjust for population shifts.

Today, one in three Americans has been diagnosed with some form of heart disease—high blood pressure, coronary heart disease, heart failure and stroke, among others—and by 2030, 116 million people in the U.S. will be diagnosed with some form of cardiovascular disease.

The panel speculated that the largest increases will be the rate of stroke and heart failure, which will rise upwards to 24.9 percent and 25 percent, respectively.

The researchers said that these increases will be due to the aging population and found that people aged 65 and over have a higher prevalence for all cardiovascular disease. This population is set to grow significantly within the next two decades.

"These increases translate to an additional 27 million people with hypertension, eight million with CHD [coronary heart disease], four million with stroke, and three million with heart failure in 2030 relative to 2010," the researchers wrote.

The costs related to hypertension alone are set to increase $130.4 billion (2008 dollars) with a total projected annual cost of $200.3 billion by 2030. The real medical costs of CHD and heart failure are estimated to increase by 200 percent over the next 20 years with stroke having the highest cost increase in real annual medical costs of 238 percent, the researchers noted.

In addition, heart disease will also produce a loss of productivity that will increase from $172 billion in 2010 to $276 billion in 2030. These losses include days missed from home or work tasks because of the illness as well as a potential loss of earnings due to premature death.

"Despite the successes in reducing and treating heart disease over the last half century, even if we just maintain our current rates, we will have an enormous financial burden on top of the disease itself," said Paul Heidenreich, MD, chair of the AHA expert panel.

"Although these projections are sobering, they need not become reality, because cardiovascular disease is largely preventable," the researchers wrote.

Heidenreich and colleagues offered that prevention strategies must be implemented to stop the growth of cardiovascular disease, a disease that accounts for 17 percent of the entirety of the nation’s health costs. The authors suggested that population-based strategies such as decreasing smoking rates, reducing dietary fat intakes and improving lipid levels, among others, can help treat high-risk individuals and help prevent their risk for cardiovascular disease. 

In addition, more personalized approaches to prevention that include assessments of genetic variants, biomarkers and imaging modalities could help tailor prevention methods and recommendations. 

But, the reserachers said, "Despite the great enthusiasm for personalized medicine, further studies are needed to determine whether these personalized approaches are superior (or complementary) to population-based approaches to cardiovascular disease prevention."

Updating and developing new guidelines for the care and prevention of cardiovascular disease, as well as using a team-based approach, could improve these outcomes and costs.

"In the public health arena, more evidence-based effective policy, combined with systems and environmental approaches should be applied in the prevention, early detection, and management of cardiovascular disease risk factors," the authors concluded. "Through a combination of improved prevention of risk factors, and treatment of established risk factors, the dire projection of the health and economic impact of cardiovascular disease can be diminished."