People living longer with cardiovascular disease, but at what cost?

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 - Grandfather

Although people are living longer with cardiovascular disease, there are likely to be both economic costs and quality of life costs associated with the longer life span. According to a study published in the October issue of Health Affairs, the combination of an aging population, the high prevalence of obesity and lower cardiovascular disease mortality will increase costs and lower quality of life.

Using data from the National Health and Nutrition Examination Surveys (NHANES), the researchers determined heart disease trends based on sex and made a number of disease-related projections.

The average 10-year cardiovascular disease risk is estimated to increase to 15.1 percent for men and 8.6 percent for women by 2030, compared with 12.7 percent and 6.8 percent in 1991. When adjusting for age, however, the projected risk in 2030 declines to 11.6 percent for men and 5.8 percent for women.

Mortality risk is expected to decline by the year 2030 to 26 percent lower for men and 16 percent lower for women. Keeping smoking or cholesterol treatment rates at 2010 levels, however, is projected to increase the risk and prevalence of heart disease. Keeping body mass index (BMI) at 2010 levels projected a lower risk. Poorer compliance with blood pressure and cholesterol treatments increased disease risk projections by 10 percent for men and 13 percent for women. Eating less saturated fat had no impact on risk or prevalence of heart disease.

These trends, the authors concluded, suggest that aging is a major factor in cardiovascular disease risk.

“In other words, 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,” wrote the researchers, led by Ankur Pandya, PhD, of Weill Cornell Medical College in New York.

If these trends continue, the authors continued, there will likely be a considerable increase in costs related to heart disease as well as considerable reductions in quality of life. To best intervene, they argued, “[p]olicies that target the treatment of high blood pressure and cholesterol and the reduction of obesity will be necessary to curb the imminent spike in cardiovascular disease prevalence.”