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CARDIOVASCULAR DISEASE: A COSTLY BURDEN FOR AMERICA — PROJECTIONS THROUGH 2035
american heart association CVD Burden Report
Recommendations
As the oldest and foremost organization dedicated to
improving the cardiovascular health of all Americans,
the American Heart Association advocates for policies
that support a robust research agenda, help prevent
cardiovascular disease and broaden access to affordable,
high quality care. To address the escalating burden of
cardiovascular disease highlighted in this report, the
association recommends the following changes in
federal policies:
• Increasing NIH research funding for heart disease
and stroke.
• Enhancing focus on prevention to improve and
preserve population health from birth to old age.
• Preserving and expanding access to high quality
affordable health care.
Research
Robust NIH-funded heart and stroke research is our
country’s best hope to discover innovative ways to prevent,
treat and ultimately develop cures for heart disease
and stroke. This analysis acknowledges the enormous
progress that has been made in the ght against CVD while
recognizing the signicant challenges that lie ahead.
Now is the time to make meaningful investment in the
NIH and the CDC. NIH-funded biomedical research has
resulted in nearly a 70 percent reduction in the death rate
for coronary disease and stroke over the past century. But,
as this analysis shows, we need to do more if we are to stop
the rising tide of CVD prevalence that is already outpacing
previous predictions.
In addition, the association supports health services,
genomics and population and epidemiological studies
conducted by other federal agencies.
There is no one-size-ts-all answer to the questions of who
gets CVD and why. This analysis clearly points out that age,
race and sex can increase risk and determine survival rates.
Given these ndings, we advocate for addressing disparities,
removing barriers to medical research and increasing
participation of women, racial and ethnic minorities, and
older Americans in clinical research. This forward thinking
is also critical in light of the higher prevalence rates among
black and older Americans, and for certain types of CVD that
disproportionately affect women and Hispanics.
Prevention
Even today, stroke and heart failure top the list of chronic
conditions that account for the most spending in the
Medicare fee-for-service program. This spending pattern
reects how the U.S. health care system often rewards
efforts that treat disease and injury rather than those that
prevent them. Cardiovascular disease is largely preventable,
and prevention programs represent an enormous return on
investment by reducing some costs and promoting patient
well-being, including length and quality of life.
Rather than treating illness when it is far advanced, the
American Heart Association advocates for heart-healthy
habits and wellness throughout a person’s life – and the
earlier the better. Those who follow a lifestyle of regular
exercise, a heart-healthy diet and regular screenings for
blood pressure, cholesterol and diabetes can dramatically
reduce their risk of developing CVD. If we have any chance
of overcoming the burden that heart disease and stroke
impose on our health care costs, our workforce productivity
and our quality of life, we have to commit to policies,
systems and environment changes that can transform
population health.
We must promote access to healthy, affordable foods and
beverages, and provide fully transparent nutrition labeling
to help keep consumers informed about food and beverage
choices and encourage healthy eating. To this end, we
strongly support federal programs that provide nutritious
foods and meals to our most vulnerable populations such
as children, older americans and low-income individuals,
including keeping nutrition standards for school meals
strong and evidenced-based.
To reverse sedentary behavior, the association supports
science-based policies that promote physical activity and
physical education in schools and early care and education;
deliver exercise prescriptions in the clinical environment;
include investments in biking and walking in transportation
infrastructure; increase and improve recreational spaces in
communities; and reduce sedentary work environments.
Prevention and control efforts have contributed to a decline
in U.S. cigarette consumption by more than 24 percent over
the past 10 years. However, new products like e-cigarettes
that are especially enticing to children have entered the
marketplace. We will continue to address CVD risk factors
such as tobacco use by strongly supporting FDA regulation
of these products; advocating for comprehensive clean
indoor air laws and increased tobacco excise taxes;
raising the purchasing age for tobacco to 21; and ensuring
comprehensive coverage of tobacco cessation services in
public and private health care plans.
Finally, a focus on prevention in the workplace is a win for
both employees and employers. Prevention strategies keep
workers healthy and productive and help employers steer
clear of economic losses from morbidity and mortality. A
2012 study conducted by researchers at the University of
Colorado found that each short-term disability claim led
because of a heart attack or hindering chest pain resulted
in nearly $8,000 in lost productivity, while long-term claims
resulted in a more than $52,000 loss to employers.