Abstract 16987: Simulation Modeling to Inform Future Population Health Interventions to Decrease the Burden of Cardiovascular Disease in the United States
Introduction: Cardiovascular disease (CVD) is the leading cause of death nationally. The US Dept. of Health and Human Services Million Hearts initiative has called attention to improving a select set of CVD risk factors, with a goal of preventing 1 million heart attacks, strokes, and other CVD events during 2012-2016. This study leverages simulation modeling to determine the key risk factors the nation should continue to focus on or begin targeting in 2017, and the expected range of events prevented through 2026 if those risk factors are addressed.
Methods: The CVD Policy Model was used to develop preliminary estimates on the 5- and 10-year impact of attaining achievable risk factor reductions on CVD non-fatal and fatal event totals and direct healthcare costs. Improvements in aspirin use for secondary prevention; blood pressure (BP), cholesterol, smoking, and obesity levels; secondhand smoke exposure; sodium intake; and diabetes incidence were assessed individually among adults aged 35-94. Risk factor goals were based on trend data, the reported effects of evidence-based interventions, and national targets.
Results: During 2017-2021, the largest event decrease is estimated to be accomplished by a 10% reduction in obesity prevalence (143,000 events prevented), which prevents CVD events via decreasing diabetes incidence and improving BP and cholesterol levels. During 2017-2026, the combined effect of achieving a 42% reduction in smoking prevalence and secondhand smoke exposure, realizing the benefits in BP lowering by reducing mean sodium intake to 2300 mg/day, attaining 75% BP control among hypertensives, and meeting the Healthy People 2020 obesity prevalence goal of 30.5% are estimated to have the greatest individual impacts on CVD events and costs, preventing 279,000, 336,000, 364,000 and 578,000 total events, resp., including 77,000, 88,000, 98,000 and 174,000 deaths, resp., and decreasing costs by $17.3, $26.4, $26.6, and $48.1 billion, resp.
Conclusions: Sizable decreases in CVD event totals, deaths, and direct medical costs would occur if the modeled risk factor reductions are achieved through 2026. This information can guide future national CVD prevention efforts by helping prioritize which risk factors should be targeted for intervention.
Author Disclosures: M.D. Ritchey: None. P. Coxson: None. Q. Yang: None. R. Merritt: None. B. Lucido: None. Y. Hong: None.
- © 2016 by American Heart Association, Inc.