Abstract 17718: Association of Ideal Cardiovascular Health in Midlife with Healthcare Costs in Later Life: the Cooper Center Longitudinal Study

Abstract

Background: The American Heart Association 2020 Strategic Impact Goals established the concept of ideal cardiovascular health (CH) which is strongly associated with lower cardiovascular (CV) event rates. However, the association between CH and healthcare costs in later life has not been reported. We hypothesized that a profile of favorable metrics of CH in midlife would be associated with lower healthcare costs in older age.

Methods: We included 4948 participants (22% women, mean age 56) free of CVD and cancer at baseline enrolled in the Cooper Center Longitudinal Study between 1970 and 2009. Seven metrics (physical activity, diet quality, smoking, body mass index, total cholesterol, blood pressure, and blood glucose) from midlife preventive medical examination were used to create a summary CH score (0-7). CH was categorized as ‘poor’ (CH score 0-2), ‘intermediate’ (CH score 3-4), or ‘favorable’ (CH score 5-7). Healthcare charges were cumulated from Medicare administrative claims data from Center for Medicare and Medicaid Services and adjusted for inflation. Associations between levels of midlife CH and healthcare charges were estimated using quantile regression adjusting for age and gender.

Results: Favorable CH was prevalent in 13.7% of men and 28.4% of women with <1% of participants having all 7 ideal CH metrics. Compared to poor CH, favorable CH was associated with 19.5% [95% CI 10.2%-27.9%, p<0.001] lower estimated total costs (see Figure). More favorable CH was associated with both lower estimated CVD and non-CVD costs, with stronger associations for CVD (71.8% [95% CI 46.6%-85.1%, p<0.001]) compared to non-CVD costs (18.7% [95% CI 3.9%-31.2%, p=0.015]).

Conclusion: A favorable profile of ideal cardiovascular health metrics in middle-aged adults is associated with lower healthcare costs in later life. These data suggest that achieving the AHA 2020 Goals could have positive implications for both CVD and non-CVD related healthcare costs.