Interventions to Reduce Cardiovascular Disease

Cardiovascular disease is a major health problem in developed and less developed countries. A study shows cost-effective interventions could lower the incidence of cardiovascular events by up to 50 percent.

Research shows systolic blood pressure above 115 millimeters of mercury accounts for two thirds of strokes and nearly half of ischemic heart disease. In addition, high cholesterol is another major risk factor for cardiovascular disease that accounts for 18 percent of strokes and 55 percent of ischemic heart disease.

Investigators from the Netherlands and New Zealand conducted research to determine the cost-effectiveness of implementing health interventions to reduce death and disability from cardiovascular disease worldwide. They specifically examined 17 non-personal and personal factors that could reduce the number of people with cardiovascular disease. Non-personal factors included health education through mass media and legislation to reduce salt content in products. Personal interventions included the detection and treatment of high cholesterol, treatment of high systolic blood pressure and treatment of individuals based on their absolute risk of a cardiovascular problem in the next 10 years.

Researchers evaluated the cost of the different interventions in 14 different regions around the world. They then determined which interventions would not only be effective at reducing cardiovascular problems, but also effective at reducing cost.

The study shows there is a potential for both personal and non-personal interventions to have a substantial effect at reducing cardiovascular events. This finding was true for both developed and less developed countries. Specifically, authors say interventions such as the government taking action to reduce the salt content of processed food could be a cost-effective way to limit cardiovascular disease. They also say treatment with blood pressure - and cholesterol-lowering drugs and with aspirin in people at risk for a cardiovascular problem in the next 10 years is a cost-effective effort. Researchers add this study challenges leaders to come up with public health strategies for less developed regions.


SOURCE: The Lancet, 2003;361:717-725