CARDIOVASCULAR DISEASE: A COSTLY BURDEN FOR AMERICA PROJECTIONS THROUGH 2035 CARDIOVASCULAR DISEASE: A COSTLY BURDEN FOR AMERICA — PROJECTIONS THROUGH 2035 american heart association CVD Burden Report CVD Burden association heart american table of contents INTRODUCTION ...................................................................................5 ABOUT THIS STUDY ................................................................................................... 6 WHAT IS CVD? ......................................................................................................... 6 Atrial Fibrillation Congestive Heart Failure Coronary Heart Disease High Blood Pressure Stroke PROJECTIONS: PREVALENCE OF CVD .............................................................7 Latest Projections Age, Race, Sex – Differences That Matter PROJECTIONS: COSTS OF CVD ................................................................. 8-11 The Cost Generators: Aging Baby Boomers Medical Costs Breakdown Direct Costs + Indirect Costs RECOMMENDATIONS .............................................................................13-14 Research Prevention Affordable Health Care 3 CARDIOVASCULAR DISEASE: A COSTLY BURDEN FOR AMERICA — PROJECTIONS THROUGH 2035 american heart association CVD Burden Report CVD Burden association heart american Introduction Cardiovascular disease (CVD) has been the leading killer In addition, CVD has become our nation’s costliest chronic of Americans for decades. In years past, a heart attack disease. In 2014, stroke and heart failure were the most or stroke almost certainly resulted in death. But advances expensive chronic conditions in the Medicare fee-for-service in biomedical research, improved emergency response program. Expenses associated with CVD are expected to systems and treatment and prevention efforts have soar in the coming years and surpass medical cost estimates helped Americans fight back. Between 2000 and 2011, for other chronic diseases, such as diabetes and Alzheimer’s. researchers found the national heart-related mortality Based on prevalence, death rates, disability and cost, CVD rate declined at an average of 3.7 percent per year, while will continue to be the most burdensome disease Americans stroke mortality declined at 4.5 percent per year. will face in the next decades. But in the past few years this remarkable progress Given these developments, it is hard to understand has stalled. why federal research funding levels for heart and stroke research are not commensurate with the number of The burden of cardiovascular disease is now growing Americans afflicted with CVD and the toll it exacts. faster than our ability to combat it due to the obesity epidemic, poor diet, high blood pressure and a dramatic Even though heart disease and stroke account for 23 percent rise in Type 2 diabetes – all major risk factors for heart and 4 percent of all deaths respectively, the National disease and stroke. In a frightening reversal, the overall Institutes of Health (NIH) invests a meager 4 percent of its decline in CVD mortality rates have flattened to less budget on heart disease research, a mere 1 percent on than 1 percent per year since 2011, and rates have even stroke research and only 2 percent on other CVD research. worsened for our most at-risk populations. In 2015, the We believe this must change and change dramatically. The death rate from heart disease actually increased by 1 stakes are too high. percent for the first time since 1969, according to the This comprehensive analysis projects what lies ahead in Centers for Disease Control and Prevention’s (CDC) CVD prevalence and costs from the present through 2035. National Center for Health Statistics. The American Heart Association hopes this tool will help guide and inform policymakers as to what we must do as a nation to reduce the heavy toll of CVD on our nation’s health and economy. 5 CARDIOVASCULARCARDIOVASCULAR DISEASE: A COSTLY DISEASE: BURDEN A COSTLY FOR AMERICA BURDEN — FOR PROJECTIONS AMERICA — THROUGH PROJECTIONS 2035 THROUGH 2035 american heart association CVD Burden Report CVD Burden association heart american About this Study cocaine. When a heart begins to fail, fluid can pool in the body; this manifests as swelling (edema), usually in the lower The association commissioned this study, and it was legs and ankles. Fluid also may collect in the lungs, causing conducted by RTI International. The goal was to project shortness of breath. the prevalence and medical costs of cardiovascular disease from the present through 2035. These new Coronary Heart Disease: Also called coronary artery projections update similar ones made by the American disease, coronary heart disease is the most common type Heart Association in 2011. of heart disease. It occurs when plaque builds up in the heart’s arteries, a condition called atherosclerosis. As plaque What is CVD? builds up, the arteries narrow, making it more difficult for blood to flow to the heart. If blood flow becomes reduced Cardiovascular disease represents a number of heart and or blocked, angina (chest pain) or a heart attack may occur. blood vessel diseases. Specifically, this study incorporates Over time, coronary artery disease can also lead to heart the prevalence and medical costs of high blood pressure, failure and arrhythmias. coronary heart disease (CHD), congestive heart failure (CHF), stroke, atrial fibrillation (AFib) and other heart High Blood Pressure: Blood pressure is the pressure of diseases from the present through 2035. Below are the blood against the walls of the arteries. When that definitions of each of these conditions: pressure is consistently above the normal range, it is considered hypertension, or high blood pressure. This Atrial Fibrillation: Atrial fibrillation is a disorder of the heart’s increases the heart’s workload, putting a person at a greater internal electrical system affecting heart rate and rhythm. risk for heart attack, angina, stroke, kidney failure and american heart association CVD Burden Report CVD Burden association heart american Also commonly abbreviated as AF or AFib, it occurs when peripheral artery disease. the heart’s two small, upper chambers (atria) beat in a fast and irregular manner and empty blood into the heart’s lower Stroke: A stroke is an interruption of blood flow to the chambers (ventricles) in a disorganized manner instead of brain, causing paralysis, slurred speech and/or altered beating effectively. Blood that isn’t pumped completely out brain function. About nine of every 10 strokes are caused of the atria when the heart beats may pool and clot. If a by a blockage in a blood vessel that carries blood to the piece of a clot enters the bloodstream, it may lodge in the brain; this is known as an ischemic stroke. The other type brain, causing a stroke. Causes of atrial fibrillation include of stroke is known as hemorrhagic, caused by a blood dysfunction of the sinus node (the heart’s pace-making area vessel bursting. Warning signs include sudden numbness in the right atrium), coronary artery disease, rheumatic heart or weakness of the face, arm or leg (especially on one disease, high blood pressure and hyperthyroidism. side); sudden confusion, trouble speaking or understanding (aphasia); sudden trouble seeing in one or both eyes; Congestive Heart Failure: Also called heart failure, sudden trouble walking, dizziness, loss of balance or congestive heart failure is when the heart can’t pump coordination; and sudden, severe headache with no known enough blood to the organs. The heart works, but not as cause. Call 9-1-1 if you think you or someone else is having well as it should. Heart failure is almost always a chronic, a stroke. long-term condition. The older you are, the more common congestive heart failure becomes. Your risk also increases if For more information on CVD, please see the American you are overweight, diabetic, smoke, abuse alcohol or use Heart Association’s Heart and Stroke Encyclopedia at heart. org/encyclopedia. 6 6 CARDIOVASCULAR DISEASE: A COSTLY BURDEN FOR AMERICA — PROJECTIONS THROUGH 2035 american heart association CVD Burden Report CVD Burden association heart american Projections: Prevalence of CVD • In 2035, the number of Americans with CVD is projected to rise to 131.2 million – 45 percent of the total U.S. “ By 2035, nearly half of the U.S. population. This means additional increases of: High Blood Pressure ...............................27.1 million population will have some form of Coronary Heart Disease ............................7.2 million cardiovascular disease.” Stroke .......................................................3.7 million Congestive Heart Failure ..........................3.0 million Cardiovascular disease has been the No. 1 killer of Atrial Fibrillation ........................................2.0 million Americans since 1920. Your great-grandparents or another Age, Race, Sex – Differences That Matter member of your family tree probably died from it. What’s more disturbing, however, is your great-grandchildren could Age, race, ethnicity or sex should not put people at a higher die from CVD, too, if we don’t take deliberate and focused risk for CVD. But unfortunately, each of these factors has action now. an impact on whether you are likely to experience a heart attack or stroke. These differences not only affect your In our 2011 projections, the American Heart Association prospects for having CVD, they also help determine your predicted that by 2030, upwards of 40 percent of the