Aggressive use of nationally recommended clinical prevention activities could increase life expectancy for U.S. adults by reducing cardiovascular disease (CVD), according to a joint report of three major national healthcare organizations: the American Heart Association, the American Diabetes Association and the American Cancer Society. Using a sophisticated mathematical model called Archimedes, senior scientists from the organizations evaluated the impact of 11 widely recognized, tailored clinical preventive services for reducing CVD, such as smoking cessation, preventive aspirin therapy, cholesterol-lowering medications and weight reduction.
The study found that:
• Using these CVD clinical preventive measures to their fullest potential could add about 220 million life-years over the next 30 years, or an average of 1.3 years of life expectancy for each adult in the U.S.
• About 78 percent of U.S. adults ages 20 to 80 are candidates for at least one of these clinical prevention activities.
• If every individual achieved 100 percent adherence with all the clinical prevention activities for which they are candidates, then heart attacks would decrease about 63 percent and strokes about 31 percent in the next three decades.
• Of the specific clinical prevention activities, the greatest benefits to the U.S. population in terms of reducing CVD come from providing aspirin to high-risk individuals, controlling pre-diabetes, weight reduction in obese individuals, lowering blood pressure in people with diabetes and lowering LDL cholesterol in people with existing coronary artery disease (CAD).
• Based on an assumption that current patterns of delivery and treatment remain the same over the next 30 years, the 11 activities varied widely in terms of their impact on CVD health outcomes and their overall cost. The results suggest that some clinical strategies are "better buys" than others in terms of cost effectiveness vis-à-vis other prevention strategies for CVD employed routinely by the current system.
"The American Cancer Society, the American Diabetes Association, and the American Heart Association have joined forces to look at clinical prevention and its impact because, although we represent different health conditions, the same prevention strategies that can significantly reduce the risk of cardiovascular diseases, including heart disease and stroke, also could reduce the risk of diabetes and cancer," said Rose Marie Robertson, MD, chief science officer of the American Heart Association and co-author of the report.
"However, our current healthcare system is not optimally designed to promote health or prevent illness," Robertson said. "The lesson from these findings is that we need a system in which we can apply these interventions in a way that is efficient and cost effective. The benefits are too important to be ignored. A healthier, more productive society is good for us all."
Source: American Heart Association, July 7, 2008
