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Value of primordial and primary prevention for cardiovascular disease: A policy statement from the American Heart Association

Weintraub, WS and Daniels, SR and Burke, LE and Franklin, BA and Goff, DC and Hayman, LL and Lloyd-Jones, D and Pandey, DK and Sanchez, EJ and Schram, AP and Whitsel, LP (2011) Value of primordial and primary prevention for cardiovascular disease: A policy statement from the American Heart Association. Circulation, 124 (8). 967 - 990. ISSN 0009-7322

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Abstract

The process of atherosclerosis may begin in youth and continue for decades, leading to both nonfatal and fatal cardiovascular events, including myocardial infarction, stroke, and sudden death. With primordial and primary prevention, cardiovascular disease is largely preventable. Clinical trial evidence has shown convincingly that pharmacological treatment of risk factors can prevent events. The data are less definitive but also highly suggestive that appropriate public policy and lifestyle interventions aimed at eliminating tobacco use, limiting salt consumption, encouraging physical exercise, and improving diet can prevent events. There has been concern about whether efforts aimed at primordial and primary prevention provide value (ie, whether such interventions are worth what we pay for them). Although questions about the value of therapeutics for acute disease may be addressed by cost-effectiveness analysis, the long time frames involved in evaluating preventive interventions make cost-effectiveness analysis difficult and necessarily flawed. Nonetheless, cost-effectiveness analyses reviewed in this policy statement largely suggest that public policy, community efforts, and pharmacological intervention are all likely to be cost-effective and often cost saving compared with common benchmarks. The high direct medical care and indirect costs of cardiovascular disease-approaching $450 billion a year in 2010 and projected to rise to over $1 trillion a year by 2030-make this a critical medical and societal issue. Prevention of cardiovascular disease will also provide great value in developing a healthier, more productive society. © 2011 American Heart Association, Inc.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Weintraub, WS
Daniels, SR
Burke, LElbu100@pitt.eduLBU100
Franklin, BA
Goff, DC
Hayman, LL
Lloyd-Jones, D
Pandey, DK
Sanchez, EJ
Schram, AP
Whitsel, LP
Date: 23 August 2011
Date Type: Publication
Journal or Publication Title: Circulation
Volume: 124
Number: 8
Page Range: 967 - 990
DOI or Unique Handle: 10.1161/cir.0b013e3182285a81
Schools and Programs: School of Nursing > Nursing
Refereed: Yes
ISSN: 0009-7322
Article Type: Review
MeSH Headings: American Heart Association; Cardiovascular Diseases--economics; Cardiovascular Diseases--epidemiology; Cardiovascular Diseases--prevention & control; Evidence-Based Medicine--standards; Humans; Risk Factors; Risk Reduction Behavior; United States
PubMed ID: 21788592
Date Deposited: 24 Sep 2012 20:01
Last Modified: 02 Feb 2019 14:56
URI: http://d-scholarship.pitt.edu/id/eprint/14309

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