By Liz Seegert
Cardiovascular disease (CVD) is the leading cause of death in the U.S. As with many other chronic conditions, age is the greatest risk factor. In 2013, someone in the U.S. died from cardiovascular disease every 40 seconds.
The average annual rates for first cardiovascular event rise drastically with age – from three per 1,000 men from 33 to 44 years old, to 74 per 1,000 men in the 85-to-94 age group. For women, comparable rate rises occur 10 years later than men.
Of the estimated 82.6 million Americans who have one or more types of cardiovascular disease, the American Heart Association says about 40 million are age 60 or older.
Many of the problems older people have with their heart and blood vessels are really caused by disease, not by aging. For example, an older heart can normally pump blood as strong as a younger heart; less ability to pump blood is caused by disease. But, changes that happen with age may increase a person’s risk of heart disease.
Cardiovascular disease is a broad category encompassing hypertension, coronary heart disease [acute myocardial infarction (AMI) and angina pectoris] stroke, heart failure, congenital heart defects, atrial fibrillation and peripheral arterial disease.
Heart disease is also expensive. The direct medical costs and indirect costs in loss of productivity from heart disease and stroke in the U.S. was $315.4 billion in 2010. Many of these expenses come more than 30 days after discharge, according to a study in JAMA Internal Medicine. Researchers found a 16.5 percent increase in spending on acute myocardial infarction between 1998 and 2008. Patients were sicker but living longer – leading to more spending on nursing home and home health care, hospice, medical equipment and other outpatient care.
Treatments such as pacemakers and defibrillators are just some of the technological advances that keep those with heart disease alive longer, but contribute significantly to the overall cost of care. Over the next 20 years, medical costs of coronary heart disease are projected to increase by about 200 percent according to the AHA. The Milken Institute predicts that the overall cost of heart disease may reach $186 billion in 2023. However, a recent study in the American Journal of Managed Care concluded that the economic burden of care for patients with CVD may be “substantially greater” than current estimates.
Facts and stats
- According to the Agency of Healthcare Research and Quality (AHRQ), 27 percent of men and 44 percent of women die within a year of having a heart attack. Of those who initially survive, 23 percent of men and 31 percent of women will have another MI within six years.
- At least 200,000 deaths from heart disease and stroke each year are preventable, according to the Centers for Disease Control and Prevention. Blacks are nearly twice as likely as whites to die from preventable heart disease and stroke.
- Each year about 1 million Americans with coronary artery disease undergo cardiac procedures to improve blood flow to the heart. Coronary artery bypass graft (CABG) surgery accounts for over half of them.
- The total number of inpatient cardiovascular operations and procedures increased 28 percent, from 5,939 000 in 2000 to 7,588 000 in 2010.
- By 2030, productivity loss from those with cardiovascular disease will cost $276 billion compared to $176 billion in 2010.
- In 2009, there were 12,826,000 physician office visits, 639,000 emergency department visits, and 589,000 outpatient department visits with a primary diagnosis of coronary heart disease. There were an additional 14,044,000 ambulatory care visits with coronary heart disease as the first-listed diagnosis.
Strategies to prevent heart attack, stroke and other major cardiac events should be individualized for older adults who should play a role in choosing their therapies, according to an updated 2013 American Heart Association scientific statement.
Statins are a standard, first-line treatment for cholesterol, which is a common risk factor for heart disease. However, as Judith Graham wrote in this New York Times article, not everyone agrees with this approach, especially when treating older adults. Reuters reported on another recent study, which found that excess body fat — even for people who are normal weight — also puts people at greater risk for heart disease.
- High blood pressure, high LDL cholesterol and smoking are key risk factors for heart disease. About half of Americans (49 percent) have at least one of these three risk factors.
- 67 million American adults (31 percent) have high blood pressure.
- About 1 in 3 American adults has prehypertension—blood pressure numbers that are higher than normal—but not yet in the high blood pressure range.
- Only about half (47 percent) of people with high blood pressure have their condition under control.
- Other risk factors for hypertension include diabetes, being overweight or obese, poor diet, physical inactivity, excessive alcohol use and smoking.
- Among Medicare beneficiaries with three or more chronic conditions, one-third have hypertension and high cholesterol along with diabetes or ischemic heart disease.
Exercise is one way of the best ways to reduce risk of heart problems, especially for older adults.
A new study published in the journal PLOS ONE found that older people who undertake at least 25 minutes of moderate or vigorous exercise everyday need fewer prescriptions and are less likely to be admitted to hospital in an emergency. Physical activity such as walking quickly, cycling or swimming leads to a higher metabolism and better circulation, reducing the risk of conditions and diseases common in older age such as high blood pressure, type 2 diabetes, coronary heart disease and strokes.
Resources
AHA Statistical Update Heart Disease and Stroke Statistics
2013 Update; A Report From the American Heart Association
CDC Interative Atlas for Heart Disease and Stroke
County-level maps of heart disease and stroke, along with maps of social environmental conditions and health services for the entire United States or for a chosen state or territory. Congressional boundaries and health care facilities can be added with an overlay.
Global Cardiovascular Infobase
Profiles of Cardiovascular and Cerebrovascular Diseases in the World is a collaborative effort headed by the World Health Organization. It provides cardiovascular data on demographics, mortality, morbidity, risk factors and related health care are linked to country maps.
2012 Chartbook on Cardiovascular, Lung, and Blood Diseases (NHLBI)
American Heart Association Interactive Cardiovascular Library
Watch animations about a variety of cardiovascular conditions, treatments and procedures.
National Heart, Lung and Blood Institute’s List of Spokepeople includes a brief bio and area of expertise. Contact the the Communications Office at nhlbi_news@nhlbi.nih.gov or 301-496-4236
American Heart Association
National media can call 214-706-1173; local media is asked to contact their local/state office (use the dropdown menu)
Becker’s Hospital Review of 25 top Cardiology Programs
Media-friendly cardiologists
Thomas Bashore, M.D., Duke University Medical Center; specialist Adult Congenital Heart Disease, Structural Heart Disease; 919-684-2407 (office); Duke Media Relations: Sarah Avery; 919-660-1306; sarah.avery@duke.edu
Nieca Goldberg, M.D., NYU Langone Medical Center; specializes in cardiovascular disease in women. Media contact: Jim Mandler, senior director for media relations, health, clinical, and research; 212-404-3525; Jim.Mandler@nyumc.org
Steven Nissen, M.D., chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, past president, American College of Cardiology. 216-444-6697 (office); media relations: 216-444-0141
James Weiss, M.D., chief, Department of Medicine, Cardiology, UCLA Ronald Reagan Medical Center, Los Angeles; 310-825-8811 (office).
Gregg Fonarow, M.D., director, Ahmanson-UCLA Cardiomyopathy Center, CHAMP – Cholesterol, Hypertension, and Atherosclerosis Management Program, clinical co-chief, Cardiology, UCLA Medical Center; 310-825-8816 (office). gfonarow@mednet.ucla.edu. Media contact: Rachel Champeau, 310-794-2270; rchampeau@mednet.ucla.edu
