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Compliance Critical Factor In Heart Treatment's Future

MANAGED CARE February 2014. © MediMedia USA
Feature

Compliance Critical Factor In Heart Treatment's Future

A bigger portion of the population is expected to have cardiac disease but live longer, and researchers argue for stopping it before it shows

Frank Diamond
Managing Editor

The costs of heart disease will go up substantially in the next decades. Using data from the National Health and Nutrition Examination Surveys to make the forecast, a recent study in Health Affairs (http://tinyurl.com/heart-data) predicts that the average 10-year risk of heart disease will rise about 15% for men and 9% for women by 2030, from a baseline of 12.7% and 6.8% in 1991.

Compliance, or lack of it, will play a huge role. The study says, “Pessimistic assumptions of 50% compliance with treatment resulted in 3 million additional cases of cardiovascular disease in 2030, compared to base-case assumption of 75% compliance.”

That’s a spread made big by the somewhat unpredictable factor of compliance with prevention methods. Take, for instance, cholesterol.

Data from the Centers for Disease Control and Prevention (http://tinyurl.com/CDC-data-brief) show that after improving in the last decade, total cholesterol levels remained constant over the last few years. The CDC would also like to see about 86% of Americans screened every five years. That number has remained stubbornly at about 70% since 1999.

Cholesterol screening rates, percentages, 2011-2012

NOTE: Screened for cholesterol is having cholesterol checked within the past 5 years.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

There is some good news in the CDC data. Fewer Americans had low levels of HDL in 2010-2011 than in 2009–2010.

Percent who had low HDL cholesterol, 2011–2012

NOTES: HDL is high-density lipoprotein. Low HDL is <40 mg/dL.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Still, not quite what health officials want to see. “Although the percentage of adults aged 20 and over with high total cholesterol declined substantially from 1999 to 2010, there was no change between 2009–2010 and 2011–2012. There was also no change in the percentage of adults screened for cholesterol. ”

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