Cardiovascular Disease: Declining Mortality, Increasing Costs and Disability

Ankur Pandya PhD Assistant Professor of Public Health in the Division of Health Policy Department of Public Health at Weill Cornell Medical Interview with:
Ankur Pandya PhD
Assistant Professor of Public Health in the Division of Health Policy
Department of Public Health at Weill Cornell Medical College What are the main findings of the study?

Dr. Pandya: Our study looked at the impact of some of the future risk factors for cardiovascular disease in the United States.  Using nine National Health and Nutrition Examination Survey waves from 1973 to 2010 we forecasted disease risk and prevalence from 2015 to 2030. We found that despite continued improvements in the disease’s treatment and declining smoking rates, increasing obesity rates, the aging population, and declining mortality from the disease should cause a rise in health care costs, disability, and reductions in the quality of life associated with increased disease prevalence. 
Were any of the findings unexpected?

Dr. Pandya: It was very interesting to see that with age-adjustment we actually saw declining cardiovascular disease risk, but we saw that risk is projected to increase after accounting for the aging population. In other words, an average 65 year-old American would be expected to be at similar (or slightly lower) cardiovascular disease risk in 2030 compared to 2010; however, there are going to be many more 65 year-olds (and older adults) in 2030, which will cause an sharp increase in overall cardiovascular disease incidence and prevalence despite improvements in age-adjusted risk. What should clinicians and patients take away from your report?

Dr. Pandya: Our findings highlight the importance of cardiovascular disease prevention in order to curb the imminent spike in the cost and health burdens expected from the disease. With these prevention goals in mind, interventions targeting obesity, high cholesterol and blood pressure, and smoking in individuals with and without the disease should be intensified. What recommendations do you have for future research as a result of this study?

Dr. Pandya: Some short-term trends (over the past 5-10 years) for obesity show a plateauing of the epidemic, while longer-term trends (over the past 30-40 years) suggest obesity will continue to rise; the implications for these trends on our cardiovascular disease projections were large, so there seems to be tremendous value in making sense of the overall trajectory of obesity, and if it is being curbed, what interventions are most effective to continue these gains. Cholesterol and blood pressure treatment levels also greatly affected our cardiovascular disease projections, so policies that improve treatment access or medication compliance should also be studied to maximize the potential benefits from improving these risk factors in future years.


More Americans Living Longer With Cardiovascular Disease Will Increase Costs While Lowering Quality Of Life

Ankur Pandya, Thomas A. Gaziano, Milton C. Weinstein, and David Cutler
Health Aff October 2013 32:101706-1714; doi:10.1377/hlthaff.2013.0449

Last Updated on October 11, 2013 by Marie Benz MD FAAD