As a youngster, I loved being part of the baby boom — it meant there were dozens of kids on my block who were ready to play hide-and-seek or join mysterious clubs. Now that I’m of an AARP age, there’s one club I don’t want to join: The one whose members have bypass scars, pacemakers, or other trappings of cardiovascular disease. The American Heart Association’s (AHA) gloomy new forecast on cardiovascular disease tells me it won’t be easy to avoid.
The AHA foresees sizeable increases in all forms of cardiovascular disease (see table) between now and 2030, the year all of the boomers are age 65 and older. Those increases will translate into an additional 27 million people with high blood pressure, eight million with coronary heart disease, four million with stroke, and three million with heart failure. That will push the number of adult Americans with some form of heart disease to 110 million.
(Percentages refer to the percentage of Americans aged 18 years and older.)
If the AHA’s projections are accurate, the cost of treating cardiovascular disease would balloon from $272 billion today to $818 billion in 2030. Add in the cost of lost productivity, and it jumps to more than $1 trillion. Yikes!
Although obesity and inactivity are part of the problem, much of the increase comes from the graying of the baby boom. We can’t stop boomers from aging, but we can fight cardiovascular disease, a condition the AHA calls “largely preventable.” Read more »
Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories. Now he has written a shorter, more accessible book Why We Get Fat: And What to Do About It to take his message to a wider audience. His basic thesis is that:
– The calories-in/calories-out model is wrong.
– Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization.
– A low-fat diet is not healthy.
– A low-carb diet is essential both for weight loss and for health.
– Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates.
He supports his thesis with data from the scientific literature and with persuasive theoretical arguments about insulin, blood sugar levels, glycemic index, insulin resistance, fat storage, inflammation, the metabolic syndrome, and other details of metabolism. Many readers will come away convinced that all we need to do to eliminate obesity, heart disease and many other diseases is to get people to limit carbohydrates in their diet. I’m not convinced, because I can see some flaws in his reasoning. Read more »
Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion.
Results appeared in a policy statement of the American Heart Association.
CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending.
The spending is associated with greater life expectancy, “suggesting that this spending was of value,” the authors wrote. But as the population ages, direct treatment costs are expected to increase substantially, even though lost productivity won’t, since seniors are employed at lower rates.
If current prevention and treatment rates remain steady, CVD prevalence will increase by about 10 percent over the next 20 years. The estimate reflects an aging population, and one that is increasingly Hispanic. To prepare for future cardiovascular care needs, the American Heart Association projected future costs. By 2030, 40.5 percent (116 million) of the population is projected to have some form of CVD. Read more »
*This blog post was originally published at ACP Internist*
The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.
Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »
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