Heart disease, stroke treatment costs to breach $500B in 2010
The projected estimated costs for cardiovascular disease (CVD) and stroke treatments in the U.S. will reach $503.2 billion in 2010, which is a 5.8 percent increase over the previous year, according to the “Heart Disease and Stroke Statistics—2010 Update,” published online Dec. 17 in Circulation.

“Undoubtedly some of these rising costs are due to adverse trends in risk factors, particularly related to the obesity epidemic,” said Donald M. Lloyd-Jones, MD, chair of the American Heart Association (AHA) Statistics Committee, and chairman of the department of preventive medicine and staff cardiologist at the Northwestern University Feinberg School of Medicine in Chicago

“We already have data to suggest that the decade-long decline in coronary death rates is flattening or reversing in younger adults, likely due to the fact that they have lived their lives with a significant burden of obesity.”

The CVD and stroke figure includes both direct and indirect costs. Direct costs include the cost of physicians and other professionals; hospital and nursing home services; prescribed medications; home health care; and other medical durables. Indirect costs include lost productivity resulting from death and disease.

From 1996 to 2006, the total number of inpatient cardiovascular operations and procedures increased by 33 percent, from 5,444,000 to 7,235,000, according to the report.

The AHA goal is, by 2020, to help improve the cardiovascular health of all Americans by 20 percent, while also reducing deaths from cardiovascular diseases and stroke by 20 percent.

“To reach the 2020 goals, Americans must start making healthier lifestyle choices,” said Lloyd-Jones. “Current statistical data show Americans to be on average overweight, physically inactive and eating a diet that is too high in calories, sodium, fat and sugar. Also, too many people are not compliant with taking prescribed cholesterol-lowering medicines that could lower their risk.”

Some statistics on risk factors from the 2010 Update:
  • Cost: In 2006, $32.7 billion in program payments were made to Medicare beneficiaries discharged from short-stay hospitals who had a principal diagnosis of cardiovascular disease – an average of $10,201 per discharge.
  • Inpatient cardiovascular operations and procedures: In 2006, an estimated 7.2 million were performed in the U.S.; 3.1 million on women.
  • Physical inactivity: 59 percent of adults who responded to a 2008 national survey reported engaging in no vigorous activity.
  • Cholesterol: Fewer than half of even the highest-risk persons are receiving lipid-lowering treatment, and only about one-third of treated patients are achieving their goal blood level of low-density lipoprotein (LDL). Fewer than 20 percent of coronary heart disease patients are at their LDL goal.
  • Obesity: Nearly 10 million children and adolescents, aged six to 19 years, have body mass index (BMI)-for-age values at or above the 95th percentile of the 2000 Centers for Disease Control U.S. growth charts. Data from 2003–06 show that 11.3 percent of children and adolescents six to 19 years of age were at or above the 97th percentile of the 2000 BMI-for-age growth chart, 16.3 percent were at or above the 95th percentile, and 31.9 percent were at or above the 85th percentile. Overweight adolescents have a 70 percent chance of becoming overweight adults. This increases to 80 percent if one or both parents are overweight or obese.

“This information shows that we’re getting very good at handling an acute event in this country,” said Lloyd-Jones. “However, the risk factor data we’re seeing now indicate a larger future burden on the healthcare system unless these trends turn around. On the flip side, risk factor management and maintaining health through prevention is infinitely cheaper than disease management and treating illness.”