AHA: Health costs for CVD to exceed $1 trillion by 2035

By 2035, CVD will place a large burden on public health and the economy, with costs rising to more than $1 trillion if left unchecked, according to a report from the American Heart Association.

“Between 2000 and 2011, researchers found the national heart-related mortality rate declined at an average of 3.7% per year, while stroke mortality declined at 4.5% per year. But in the past few years this remarkable progress has stalled,” the AHA report states. “The burden of [CVD] is now growing faster than our ability to combat it due to the obesity epidemic, poor diet, high [BP] and a dramatic rise in type 2 diabetes — all major risk factors for heart disease and stroke.”

The new projections are an update from a report released in 2011, which estimated that 100 million Americans would have CVD by 2030; however, that number was achieved in 2015, 15 years before expected.

In this study, researchers project that by 2035 123.2 million Americans will have hypertension, 24 million will have CHD, 11.2 million will experience a stroke and 7.2 million will have atrial fibrillation.

In less than 2 decades, black Americans are projected to have the highest rates of CVD, followed by Hispanics, and men are projected to have a higher rate than women. Additionally, at age 45 years an individual’s CVD risk will be 50%, and at age 65 years it will be 80%.

Rising costs

Besides the increased incidence rate of CVD, the associated costs — both direct medical costs and indirect costs due to lost productivity in the workplace — are expected to rise, according to the report. For Hispanic adults, the medical costs are expected to triple by 2035, and for black adults they are predicted to more than double in that same period. CVD expenses will surpass medical cost estimates for other chronic diseases, such as diabetes and Alzheimer’s disease, by 2035, according to the study.

Lost productivity because of CVD is expected to cost employers nearly 60 hours and more than $1,100 per year for every employee living with the disease.

Stroke and HF account for the most spending in the Medicare fee-for-service program among chronic conditions.

“This spending pattern reflects how the U.S. health care system often rewards efforts that treat disease and injury rather than those that prevent them,” the researchers wrote. “[CVD] is largely preventable and prevention programs represent an enormous return on investment by reducing some costs and promoting patient well-being, including length and quality of life.”

Focusing on prevention

The AHA proposes changes in federal policy to address the burden of CHD in the next 2 decades. Specifically, it proposes increased funding for heart disease research from the NIH. Currently, the NIH invests only 4% of its budget on heart disease, despite heart disease accounting for 23% of all deaths.

Additionally, the report suggests an enhanced focus on prevention and preservation and expansion of access to high-quality affordable health care.

Under the Affordable Care Act, patients are able to access prevention programs, including BP and cholesterol screenings, smoking cessation services, behavioral counseling for obesity, as well as improved access to primary care and medications that call help reduce risk and manage disease.

The study estimates that 50% of adults younger than 65 years have a pre-existing condition that would have precluded them from health insurance coverage under the rules in most states before the Affordable Care Act.

“Our lawmakers should pay close attention to these projections as they deliberate changes to the Affordable Care Act and the health care system,” Steven Houser, PhD, FAHA, AHA president, said in a press release. “If we are to avert this looming crisis, we must maintain access to health care coverage by protecting the ban on pre-existing conditions and enabling everyone to take advantage of an important weapon against CVD — prevention.” – by Cassie Homer

Disclosure: The researchers report no relevant financial disclosures.