Healthnotes Newswire (August 21, 2008)—A new study shows the cost of heart disease prevention treatments—including medications to control related health issues and programs to stop smoking and lose weight—could be high. Circulation reports that while these prevention strategies could reduce heart attacks by 63% and stroke by 31%, the current price tag of delivering these strategies will increase overall healthcare costs.

Fortunately, the impact of these findings is mitigated by the many diet and lifestyle steps that are well-known to decrease disease risk, but were not factored into the results as they were difficult to measure in the study design.

Calculating the cost of prevention

About 78% of all people ages 20 to 80 are candidates for heart disease prevention strategies, such as medications to lower cholesterol, blood pressure, and blood sugar; aspirin therapy; and smoking cessation and weight loss programs. The new study used a mathematical model to simulate these prevention activities and to answer questions about how they may reduce heart disease risk, improve quality of life, and add years to life. The cost of implementing these changes was estimated and compared with current healthcare expenditures.

By fully utilizing all the heart disease prevention strategies, researchers estimated that more than 27 million heart attacks and 10 million strokes could be prevented over the next 30 years, reducing the cost of caring for cardiovascular disease and related illnesses by almost 10%. Implementing the strategies would also improve quality of life and extend lifespan by an average of 1.3 years.

“The greatest benefits to the population 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 (“bad”) cholesterol in people with existing coronary heart disease,” said the study’s authors. Most of these strategies are pricey, though, and total healthcare costs would increase by 162%. Smoking cessation was the only prevention activity projected to save money.

Looking at lifestyle factors

Fortunately for the everyday person, the model did not consider behavioral changes like exercise and dietary modification, which can have a profound effect on cardiovascular disease risk, often without taxing the pocketbook. “It wasn’t possible to quantify the effects of certain dietary changes or exercise on heart disease risk using this model,” said Dr. Kahn.

Lifestyle changes such as the following can make a big difference when it comes to preventing heart disease:

• Regular aerobic exercise can improve heart health by aiding in weight loss, lowering blood pressure, and decreasing the risk of diabetes by improving insulin sensitivity.

• Diets low in saturated fat that include fish such as salmon and rainbow trout, plenty of vegetables, legumes, nuts, seeds, and whole grains may help lower cholesterol and support healthy function of blood vessels.

“There is enormous benefit to be had by employing the interventions we studied, and several of them are cost effective,” said Dr. Richard Kahn, the study’s lead author. “Now we need to look for ways to make the costlier interventions more affordable.”

(Circulation 2008;118:epub ahead of print)