Feature Article

Keeping Up the Fight Against Heart Disease

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Cardiovascular disease is a classic “good news, bad news” story. Although improved treatments have led to lower death rates, an aging and overweight population poses challenges for the U.S. health care system, experts said at a recent briefing in Washington, D.C.

“The real transformative way for us to address cardiovascular disease will be from science and discoveries that translate into optimal medical care,” said Daniel Perry, executive director of the nonprofit Alliance for Aging Research, which co-sponsored the Capitol Hill briefing in February with the American Heart Association and the Heart Rhythm Society.

"Nearly 80 million American adults – one in three – has one or more types of cardiovascular disease, an umbrella term for many types of heart and blood-vessel diseases, including coronary heart disease, high blood pressure and stroke."

Medical research of the past 30 years has paid off in the form of better diagnostic tools, surgical treatments and drugs, leading to lower death rates from heart disease and stroke in both men and women. From 1994 to 2004, the death rate from cardiovascular disease fell by 25 percent, according to the AHA.

Still, the prevalence of this disease is a huge concern. Nearly 80 million American adults – one in three – has one or more types of cardiovascular disease, an umbrella term for many types of heart and blood-vessel diseases, including coronary heart disease, high blood pressure and stroke.

“Cardiovascular disease remains the leading cause of death in the United States,” Dr. Raymond J. Gibbons, president of the AHA and a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn., told the audience of legislative staff and health advocacy organizations.

The disease caused 871,500 U.S. deaths in 2004, or 36.3 percent of the total, AHA statistics show. In every year since 1900, except 1918, cardiovascular disease has accounted for more deaths than any other cause.

The number of cardiovascular-related deaths is expected to rise because certain risk factors – advanced age, diabetes and overweight and obesity – are rising, Gibbons said. “If you live long enough, you’ll get cardiovascular disease. That’s the reality,” he added. “There’s going to be an epidemic of cardiovascular deaths.”

The attendant human suffering will be compounded by financial difficulty, as Medicare and other insurers strive to pay for treating “the silver tsunami” of patients, Perry pointed out. Cardiovascular disease will cost the nation about $431.8 billion this year in medical costs and lost productivity.

Building on Past Successes

But, if the past is any guide, the expected burden will be blunted by successes in medical research that ultimately lead to better prevention and treatment of heart disease and stroke. Take high blood pressure drugs, for example.

Antihypertensives reduced average blood pressure in men by 10 percent to 11 percent and in women by 10 percent to 13 percent in 2000, compared with what their blood pressure would have been in the absence of these drugs, health economist Genia Long said. The medications also obviated hundreds of thousands of hospitalizations and premature deaths.

Long, vice president of Analysis Group Inc., a Boston consulting firm, says her study, published in the Jan./Feb. 2007 issue of Health Affairs, shows that high blood pressure medications have led to more years of life and billions of dollars in avoided costs. The payoff would be even bigger if more people who need the drugs took them, she noted.

One person enjoying more years of life is Juddson Rupp, 41, who survived sudden cardiac arrest during a morning workout six years ago. A doctor who happened to be at the gym came to his rescue and performed CPR until the ambulance arrived. In the hospital, Rupp received an implantable cardioverter defibrillator, a device that monitors his heart rhythm and, if needed, passes an electric current through his heart to help prevent another attack.

“You really need to pay attention to your health,” said Rupp, a television-station account executive and father of two from Charlotte, N.C.

The technology that saved Rupp’s life is one of many medical advances that are helping millions of Americans with heart disease live longer, healthier lives. Gibbons, Perry and others urged the government to better fund cardiovascular research to continue its successful track record. Gibbons said, “We need to preserve the advances from past research…or the storm clouds are going to overwhelm us.”

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