By all indications, we are facing a global pandemic. Cardiovascular diseases (CVD) are the cause of more than 50% of deaths, not only in developed countries, but the World Health Organization (WHO) estimates that low- and middle-income countries are significantly affected. disproportionate: 82% of CVD deaths occur in low- and middle-income countries and occur almost equally in men and women. The WHO projects that by 2030, almost 23.6 million people will die of CVD. These are expected to remain the leading causes of death. The largest percentage increase will occur in the Eastern Mediterranean Region. The largest increase in the number of deaths will occur in the South-East Asia Region.
CVD costs involve: Direct costs that include expenses for hospital care, prescription drugs, medical care, care in other institutions and additional health expenses such as for other professionals, capital costs, public health, health research, etc.; plus indirect costs: includes the value of economic output lost due to disability, whether short or long term, or as a consequence of premature mortality; Other costs may include the value of time lost from work and/or leisure activities by family or friends caring for patients.
CVDs are a group of disorders of the heart and blood vessels that include:
• coronary heart disease – disease of the blood vessels that supply the heart muscle
• cerebrovascular disease – disease of the blood vessels that supply the brain
• hypertension – high blood pressure
• peripheral arterial disease – disease of the blood vessels that supply the arms and legs
• rheumatic heart disease: damage to the muscle and valves of the heart from rheumatic fever, caused by streptococcal bacteria.
• heart failure: a condition in which a problem with the structure or function of the heart affects its ability to supply enough blood flow to meet the body’s needs
• congenital heart disease: malformation of the structure of the heart existing at birth
• Deep vein thrombosis and pulmonary embolism: blood clots in the veins of the legs, which can break free and move to the heart and lungs.
Heart attacks and strokes are usually acute events and are primarily caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is the buildup of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain or by blood clots.
CVD burden should not be measured solely by deaths. CVD leads to overwhelming economic costs, as well as human burdens. Cardiovascular diseases cost EU healthcare systems just under $260 billion, representing a per capita cost of more than $500 per year, representing 10% of healthcare spending across the EU. Looking at these direct costs vastly underestimated the actual costs of CVDs. Production losses due to death and disease amounted to USD 55 billion. The cost of informal care for CVD patients is another major non-health cost, estimated at just under USD 60 billion. These are just the economic costs…the true cost in human terms of suffering and lives lost is incalculable.
According to the American Heart Association and the National Heart, Lung, and Blood Institute, the staggering burden of CVD in the United States, including health care expenses and lost productivity from death and disability, is projected to be more than $475 billion. in 2009. For comparison, in 2008, the estimated cost of all cancers and benign tumors was $228 billion.
The economic burden of CVDs is no longer an exclusive concern of the wealthy, industrialized world. With the exception of sub-Saharan Africa, CVDs are the leading cause of death in the developing world. The economic impact is felt both as a cost to health systems, as well as the loss of income and production of those directly affected by the disease and the caregivers of people with CVD, who stop working.
This is exacerbated in the developing world, where CVDs affect a high proportion of working-age adults. In China, direct costs are estimated at more than USD 40 billion of 4% of gross national income. In South Africa, 25% of the country’s health spending is dedicated to cardiovascular diseases. Researchers have already estimated that among the developing economies of Brazil, India, China, South Africa, and Mexico, 21 million years of future productive life are lost to CVD each year. New studies suggest that obesity recently overtook smoking as the “major modifiable risk factor” affecting length and quality of life. Smoking has long been known as the number one cause of cardiovascular disease, lung cancer, emphysema, and a variety of other health problems. It is estimated that two-thirds of Americans are overweight, 50 percent of whom are actually obese. The Mayo Clinic defines obesity as “an excessive amount of body fat that is more than just a cosmetic concern.”
According to the Center for Disease Control (CDC), obesity increases the risk of heart disease, diabetes, cancer, hypertension (high blood pressure), stroke, sleep apnea, and osteoarthritis. What is starting is that obesity is gradually becoming a more frequent risk factor than smoking. For years, we’ve heard how smoking is the number one cause of a variety of life-threatening diseases and conditions, including lung cancer, emphysema, and heart disease; however, recent studies have suggested that obesity is beginning to eclipse the risks of smoking and drinking combined, and at an alarming rate. In 2008, obesity was estimated to cost the US $147 billion and 2010 shouldn’t be much of a relief. In fact, Thomson Reuters estimates that obese people will spend an average of 40 percent more in healthcare costs, or $1,429 more per year, than people within a “normal weight range,” in the coming years. The most widespread costs of cardiovascular disease are related to the incidence of heart failure, which increases with age. In 2000, approximately 12.7 percent of the US population was 65 or older. It is estimated that in 2020, 16.5 percent will be in this age group.
According to the CDC, among US residents who have heart failure, 70 percent are 60 years or older, indicating that the prevalence of heart failure is expected to rise significantly in the coming years. Ironically, another factor that has resulted in an increase in the number of people living with heart failure is the success in treating heart attacks. The most effective treatments have resulted in better survival rates after heart attacks. According to the CDC, more than 20 percent of men will develop heart failure within six years of a heart attack. An even higher percentage (more than 40 percent) of women will experience heart failure within that time frame after having a heart attack. Together, an aging population and a better medical outlook for heart attack victims explain why the annual incidence of heart failure has roughly tripled in the past 10 years.
These factors will also increase the economic impact of heart failure. This is true despite the fact that the survival of patients with heart failure has improved due to treatment with heart medications. Human cost Heart failure exacts a cost to patients and their families in terms of the additional difficulty patients have in carrying out their normal daily activities. This human cost was further examined in a recent study by scientists at the University of Michigan Health System and the Veterans Administration Ann Arbor Health System, based on survey responses from 10,626 heart failure patients from 65 years or older. The study revealed that, compared to people without the condition, people with heart failure:
• You are much more likely to be disabled
• You are much more likely to have difficulty with normal daily activities, including things like walking across the room.
• You are more likely to be in nursing homes
• More likely to have been in a nursing home in the past two years
• More likely to receive home care
• Increased likelihood of having experienced clinical conditions that are more common in older adults (such as self-injury due to a fall, urinary incontinence, and dementia)
The main factor determining the cost of heart failure treatment is the high incidence of hospitalization. A large percentage of the healthcare costs associated with heart failure are due to the need to hospitalize patients. Patients with heart failure are at high risk of hospitalization. Results from a National Hospital Discharge Survey show that the number of hospitalizations for heart failure has increased substantially, from more than 400,000 in 1979 to more than 1.1 million in 2004, representing nearly 2 percent of all admissions. hospitals in the United States.
According to the Centers for Disease Control, among people with Medicare, heart failure is the most common reason for hospitalization. Readmission rates within six months after discharge are as high as 50 percent. The top three causes of hospitalization for patients with heart failure are fluid overload (55 percent), angina (chest pain) or heart attack (25 percent), and irregular heart rhythms (15 percent). Effective treatment for fluid overload is increasingly needed, not only to improve the prognosis of patients with heart failure, but also to improve their quality of life. Repeat hospitalizations bode poorly for a patient’s prognosis and quality of life, and also lead to increased health care costs.
In 2009, Dr. Eldon Smith’s presentation of Canada’s first comprehensive heart health strategy and action plan stated that “cardiovascular disease (heart disease and stroke) is the leading threat to public health and death in Canada , and cost the economy more than $22 billion annually.” This is more than $600 for every man, woman, and child without attempting to quantify the years lost, the quality of life lost, and the love lost.