Value of primordial and primary prevention for cardiovascular disease

A policy statement from the American Heart Association

William S. Weintraub, Stephen R. Daniels, Lora E. Burke, Barry A. Franklin, David C. Goff, Laura L. Hayman, Donald Lloyd-Jones, Dilip K. Pandey, Eduardo J. Sanchez, Andrea Parsons Schram, Laurie P. Whitsel

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)967-990
Number of pages24
JournalCirculation
Volume124
Issue number8
DOIs
StatePublished - Aug 23 2011
Externally publishedYes

Fingerprint

Primary Prevention
Cardiovascular Diseases
Cost-Benefit Analysis
Public Policy
Pharmacology
Costs and Cost Analysis
Benchmarking
Cost of Illness
Tobacco Use
Acute Disease
Sudden Death
Health Care Costs
Life Style
Atherosclerosis
Salts
Stroke
Myocardial Infarction
Clinical Trials
Exercise
Diet

Keywords

  • AHA Scientific Statements
  • cardiovascular diseases
  • prevention

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Weintraub, W. S., Daniels, S. R., Burke, L. E., Franklin, B. A., Goff, D. C., Hayman, L. L., ... Whitsel, L. P. (2011). Value of primordial and primary prevention for cardiovascular disease: A policy statement from the American Heart Association. Circulation, 124(8), 967-990. https://doi.org/10.1161/CIR.0b013e3182285a81

Value of primordial and primary prevention for cardiovascular disease : A policy statement from the American Heart Association. / Weintraub, William S.; Daniels, Stephen R.; Burke, Lora E.; Franklin, Barry A.; Goff, David C.; Hayman, Laura L.; Lloyd-Jones, Donald; Pandey, Dilip K.; Sanchez, Eduardo J.; Schram, Andrea Parsons; Whitsel, Laurie P.

In: Circulation, Vol. 124, No. 8, 23.08.2011, p. 967-990.

Research output: Contribution to journalArticle

Weintraub, WS, Daniels, SR, Burke, LE, Franklin, BA, Goff, DC, Hayman, LL, Lloyd-Jones, D, Pandey, DK, Sanchez, EJ, Schram, AP & Whitsel, LP 2011, 'Value of primordial and primary prevention for cardiovascular disease: A policy statement from the American Heart Association', Circulation, vol. 124, no. 8, pp. 967-990. https://doi.org/10.1161/CIR.0b013e3182285a81
Weintraub, William S. ; Daniels, Stephen R. ; Burke, Lora E. ; Franklin, Barry A. ; Goff, David C. ; Hayman, Laura L. ; Lloyd-Jones, Donald ; Pandey, Dilip K. ; Sanchez, Eduardo J. ; Schram, Andrea Parsons ; Whitsel, Laurie P. / Value of primordial and primary prevention for cardiovascular disease : A policy statement from the American Heart Association. In: Circulation. 2011 ; Vol. 124, No. 8. pp. 967-990.
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