Cardiovascular Disease  /  Human Value

Approximately 85.6 million Americans suffer from some form of cardiovascular disease (CVD) and close to 1 in 3 deaths result from CVD. These are not only deadly but costly diseases with CVD and stroke costing around $320 billion each year.

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    • The rate of hospitalization from heart failure before and after transcatheter mitral valve repair (TMVR) decreases 73% (per patient year) in patients at prohibitive surgical risk.
       
    • The volume of mitral valve surgical procedures increased approximately 8.3% from 2010 to 2013.
       
    • TAVR improves quality of life in SAS patients
       
    • Survival rates of patients ages 65-75 with valve repair and replacement
       
    • From approval in 2011 through 2015 >54,000 TAVRs were performed in 418 centers in 48 states
       
    • Survival rates of SAS patients ages 80+ with and without SAVR
       
    • In 2010, ~67,500 SAVRs were performed in the U.S.
       
    • Satisfaction rates of heart valve disease patients with their treatment
       
    • Disease specific status and generic health status improvements from TAVR and SAVR
      Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in intermediate risk symptomatic aortic stenosis (SAS) patients were associated with significant improvements in disease specific status (16 to…  
    • Satisfaction with HVD Treatment
      Among treated heart valve disease (HVD), 96% express “full satisfaction” and 78% are “very satisfied” with their treatment.  
    • Improvements in QoL from TAVR in SAS patients
      Symptomatic aortic stenosis (SAS) patients who underwent transcatheter aortic valve replacement (TAVR) experienced quality of life (QoL) improvements from 5.3 at baseline (10 point scale with 10=best imaginable health state)…  
    • TAVR Success in sSAS Patients
      A study of severe symptomatic aortic stenosis (sSAS) patients who received transcatheter aortic valve replacement (TAVR) found 30-day mortality of 2.2% for those who were high risk of surgical mortality/inoperable,…  
    • TAVR Procedures 2011 – 2015
      From approval in 2011 through 2015, >54,000 transcatheter aortic valve replacements (TAVRs) were performed in 418 centers in 48 states.  
    • TAVR v. SAVR in Intermediate-Risk SAS Patients
      At 1-year, severe aortic stenosis (SAS) patients with intermediate surgical mortality risk who underwent transcatheter aortic valve replacement (TAVR), had all-cause mortality rates of 7.4% (compared to 13% for surgical…  
    • Survival Rates of SAS Patients with and without SAVR
      Patients with severe aortic stenosis (SAS) ages 80+ who underwent surgical aortic valve replacement (SAVR) have 1-year, 2-year, and 5-year survival rates of 87%, 78%, and 68% respectively — compared with…  
    • Surgical Aortic Valve Replacements in 2010
      In 2010, ~67,500 surgical aortic valve replacements (SAVR) were performed in the U.S.  
    • Undertreatment of patients with sSAS
      AS is often undertreated — one study found that 56% of severe symptomatic aortic stenosis (sSAS) patients referred to a cardiothoracic surgeon were not operated on.  
    • Cardiovascular disease death rates
      Cardiovascular disease accounts for nearly 801,000 deaths in the US, or about 1 of every 3 deaths in the US.  
    • A study exploring the decline in deaths attributable to cardiovascular disease in the U.S. from 1980 to 2000 suggested that approximately 47% of the decrease was due to the increased…  
    • Between 1998 and 2008, the stroke death rate fell 34.8%. The actual number of stroke deaths declined 19.4%.  
    • Between 1998 and 2008, the rate of death attributable to cardiovascular disease declined 30.6%.  
    • Effectiveness of an oral pharmacologic agent in preventing venous thrombosis
      An oral pharmacologic agent has been demonstrated to be at least as effective as an injectable anticoagulant in the prevention of venous thrombosis following hip replacement.  
    • Direct thrombin inhibitor reduced relative risk of venous thromboembolism
      An investigational direct thrombin inhibitor reduced relative risk of venous thromboembolism after total hip replacement surgery by 65.7%—compared to a currently available treatment.  
    • Anti-platelet therapy stroke risk reduction
      Anti-platelet therapy after a stroke or TIA reduces the risk of nonfatal ischemic strokes by 28% and fatal strokes by 16%.  
    • Aspirin as stroke prevention
      Aspirin reduces stroke rate by 20% in patients with myocardial infarction.  
    • Pioglitazone associated with relative risk reduction in recurrent stroke
      The PROactive trial to manage glucose in diabetics with a history of cardiovascular disease, stroke, or other vascular risk factors found that treatment with pioglitazone was associated with a 47% relative…  
    • Antihypertensive drugs used to reduce stroke recurrence
      Treatment of high blood pressure with antihypertensive drugs is associated with a significant reduction in risk of recurrent stroke.  
    • Lowering blood pressure associated with reduction in stroke risk
      Lowering of blood pressure is associated with a 30% to 40% reduction in stroke risk.  
    • Effectiveness of treating ischemic stroke victims with rt-PA within 3 hours of symptom onset
      A study of the effectiveness of treating ischemic stroke victims with rt-PA within 3 hours of symptom onset found an estimated impact on long-term health outcomes of 564 quality-adjusted life-years saved…  
    • Identifying individuals at high risk for developing AFib
      Using simple bedside measures, identification of individuals at risk for developing atrial fibrillation is feasible. Selecting high-risk individuals for inclusion in atrial fibrillation prevention trials may also enhance prevention strategies.  
    • Catheter ablation reduces risk of stroke and death among AFib patients
      Atrial fibrillation patients who underwent catheter ablation had a reduced risk of stroke and death—2.2% of those who had ablation experienced stroke versus 4.7% on medications alone, and 6% died from…  
    • Decrease in AFib hospitalization rates
      The use of practice guidelines in atrial fibrillation patients saw a decrease in rate of hospitalization from 74%to 38%.  
    • Stroke risk reduction from thrombin inhibitor in AFib patients
      A recently approved direct thrombin inhibitor was found to reduce the risk of stroke/peripheral embolic events in atrial fibrillation patients by 34%, and the risk of hemorrhagic stroke by 74%—compared…  
    • Adjusted-dose warfarin reduced stroke risk in AFib patients
      Meta-analysis of randomized trials found that adjusted-dose warfarin reduced stroke risk in atrial fibrillation patients by 60%. Antiplatelet agents reduced risk by 20%.  
    • Aspirin use in AFib patients
      Meta-analysis of a number of randomized controlled trials found that aspirin use in atrial fibrillation patients reduced stroke risk by an average 22%.  
    • Stroke rates among Afib patients
      In one year, 58,283 of the 1.265 million Medicare beneficiaries with atrial fibrillation that did not receive prophylaxis suffered a stroke. For those who did receive anti-coagulants, 38,468 suffered strokes.  
    • Death rates from heart disease and stroke are falling in-part because of new drug treatments. According to the National Heart, Lung and Blood Institute, if death rates were the same…  
    • The use of ACE inhibitors in hypertensive patients 80 years of older was associated in this study with a 30% reduction in the rate of stroke and a 64% reduction…  
    • A study looking at the effects of cardiovascular medicines in elderly patients who had previous heart attacks, found a total death rate reduction of 24% between 1995 and 2004.  
    • Beta-Blocker Treatment After A Heart Attack: Trends, 1996-2006  
    • The rise in beta-blocker treatment rates (34% since 1996) is proof that sustained attention and effective initiatives saves lives and improves quality of life.  
    • In 1996, fewer than 2 in 3 patients were receiving beta-blocker drugs to prevent a second heart attack. In 2006, more than 97% of heart attack patients received these treatments,…  
    • Between 1981 and 2004, death rates for heart disease and stroke declined by about 44%.  
    • Trends in carotid endarterectomy procedures  
    • From 1979 to 2005, the total number of inpatient cardiovascular operations and procedures increased 484% to 6,989,000 annually.  
    • In 2005, approximately 469,000 coronary artery bypass procedures were performed on 261,000 patients in the U.S.  
    • From 1979 to 2005, the number of cardiac catheterizations increased 342% to 1,322,000 annually.  
    • In 2005, 2,125 heart transplantations were performed in the U.S.  
    • In 2005, an estimated 1,271,000 inpatient angioplasty procedures, 469,000 inpatient bypass procedures, 1,322,000 inpatient diagnostic cardiac catheterizations, 91,000 inpatient implantable defibrillators, and 180,000 pacemaker procedures were performed for inpatients in the…  
    • Between 1988 & 1994 and 1999 & 2004, use of pharmacological lipid-lowering treatment increased from 11.7% to 40.8%. Low-density lipoprotein cholesterol control increased from 4.0% to 25.1% among those with high…  
    • From 1994 to 2004, death rates from cardiovascular disease declined 24.7%.  
    • About 1/2 of the decrease in recent deaths in cardiovascular disease can be attributed to medical treatment.  
    • Antihypertensive therapy has been associated in clinical trials with a 1/3 reduction in stroke incidence, a 1/4 reduction in myocardical infarctions and a more than 1/2 reduction in heart failure.  
    • From 1970-2000, gains in longevity were greatest for people between the ages of 40 and 60, and greater for men than women, in large part because of advances in the…  
    • Data from clinical trials demostrate that ICDs reduce sudden cardiac death 5-10% per year for 2-3 years, compared to antiarrhythmic drugs.  
    • 5 years of treatment with beta-blockers for heart failure increases patient survival by about 3 1/2 months and patients had fewer overnight hospital stays.  
    • In the 1980s, approximately 400,000 major infarctions were occurring each year in the U.S. and 40% of patients were dying within the first year. 1-year mortality is now 4-8%.  
    • Every year, around 250,000 Americans have an automatic intracardiac defibrillator (ICD) implanted. Data from clinical trials that compares ICDs to antiarrhythmic drugs show that the ICDs reduce sudden cardiac death…  
    • “Although high cholesterol was recognized as a key risk factor for cardiovascular disease in the 1970s, there were no good ways to reduce it. The best drug available was…  
    • Ischemic stroke patients treated with t-PA (a drug used to treat blood clots) within 3 hours of onset are 33% more likely to be free of disability 3 months after…  
    • About 70% of the survival improvement in heart attack mortality resulted from changes in technology.  
    • Since 1950, reduction in heart disease mortality has added more than 3 1/2 years to the expected lifetimes of both men and women.  
    • Mortality rates in the first 3 months after a heart attack have fallen by about 75%.  
    • Increased use of non-acute medications in primary and secondary prevention explains about 1/3 of the total reduction in cardiovascular disease mortality since 1950.  
    • About 2/3 of reduced mortality from cardiovascular disease is a result of medical interventions.  
    • An estimated 70% of survival improvement in heart attack mortality is attributed to technological advances and procedures developed over the past 30 years, including CABG (coronary artery bypass graft), PTCA…  
    • Aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and statins, when taken in combination, have been estimated to reduce the relative risk of coronary heart disease mortality by 80%, compared with a placebo.  
    • The greater use of medications and revascularization would provide approximately a 17% reduction in 2 year mortality combined.  
    • Compared to predicted levels in the absence of drug therapy, there were 9% fewer deaths from major cardiovascular disease in 2001 and 38% and 25% fewer hospital discharges for stroke…  
    • It is estimated that the number of quality-adjusted life-years achieved with each $1 million spent on antihypertensive drug therapy is between 20-50 to more than 200.  
    • If all untreated patients with Stage I or II hypertension had been treated and achieved normal blood pressures, there would have been 420,000 fewer hospital discharges in 2002 than actually…  
    • Without antihypertensive drug therapy, there would have been about 572,000 more hospital discharges for stroke in 2002 and 261,000 more discharges for myocardial infarction.  
    • In 2001, 86,000 more premature deaths from cardiovascular disease (50,000 men and 36,000 women) would have occurred among Americans age 40 and older without antihypertensive drug therapy.  
    • From 1999-2000, average blood pressures for Americans age 40 and older would have been 10-13% higher without antihypertensive drug therapy.  
    • Cardiovascular disease mortality has declined by over 50% since 1950, contributing more than any other factor to the increase of life expectancy during the past few decades.  
    • Antihypertensive therapy has had a major impact on health. Without it, 1999-2000 average blood pressures (at age 40 or over) would have been 10-13% higher, and 86,000 more premature deaths…  
    • Major cardiovascular event rates could be reduced by 80% simply by acting on known risk factors with therapies already shown to be effective.  
    • Because of the advent of imaging and noninvasive testing, Americans who are asymptomatic are being diagnosed with established cardiovascular disease.  
    • “Both echocardiography and nuclear imaging are used for provocative “stress” testing of the heart. When combined with exercise or other forms of stress such as administering inotropic or vasodilating drugs,…  
    • Antihypertensive Medicines Have Prevented Deaths and Hospitalizations: Study quantified impact of high blood pressure drugs on the U.S. population 1999-2000  
    • Increased Use of Medicines Reduces Risk of Death After Major Cardiovascular Events: Disease management program increased use of medicines  
    • Medicines Produce Valuable Health Gains for Heart Attack Patients  
    • Increased use of a blood-thinning drug prevents 40,000 strokes every year in the U.S.  
    • In 1995, an NIH-funded clinical trial established the first FDA-approved treatment for acute ischemic stroke treatment.The drug tPA, if given within 3 hours of stroke symptoms, reduces the risk of…  
    • The age-adjusted stroke mortality rate has decreased 70% since 1950, and 64% since 1972.  
    • Echocardiography and nuclear imaging are used for provocative “stress” testing of the heart. When combined with other forms of stress, both can identify the presence of coronary artery-obstructing lesions that…  
    • Atrial fibrillation ablation prevents recurrence of AFib
      Atrial fibrillation ablation, which involves using a catheter inserted into the heart to destroy electrical conduction tissue in or near the atria, prevents the recurrence of atrial fibrillation in up…  
    • Over 1 million angioplasty-stent procedures are estimated to be performed each year in the U.S.  
    • Over the past 15 years, three classes of drugs have reduced mortality and improved symptoms of heart failure in patients who have decreased heart muscle function. These classes of drugs…  
    • Through advances in risk-factor assessment, detection, and preventive strategies, the average age of acute myocardial infarction and heart failure patients has shifted around 10 to 15 years forward. One-year…  
    • “Increasing life expectancy in western society is a result of two major success stories in the prevention and treatment of human disease. The first milestone was eliminating the scourge of…  
    • “Over the past thirty-five years, U.S. age-adjusted mortality from cardiovascular disease declined 50 percent. This marked reduction reflects advances in the prevention, diagnosis, and treatment of common cardiovascular conditions.”  
    • In the absence of antihypertensive drug therapy, there would have been an estimated 572,000 more hospital discharges for stroke in 2002, and 261,000 more discharges for myocardial infarction. The…  
    • Without antihypertensive therapies, blood pressures (at age 40+) would have been between 10% and 13% higher in 1999-2000. Additionally, 86,000 excess premature deaths from cardiovascular disease would have occurred in…  
    • Death rates from stroke have decreased from 180.7 per 100,000 persons in 1950, to 56.2 per 100,000 persons in 2002.  
    • Death rates from heart disease have decreased from 586.6 deaths per 100,000 persons in 1950, to 240.8 deaths per 100,000 persons in 2002.  
    • The percentage of Americans age 55-64 with high cholesterol decreased between 1988-94 and 1999-2002, in part because of the increased awareness about the risks of high cholesterol and the increased…  
    • Death Rates for Coronary Heart Disease, 1950-1998  
    • Because of reduced mortality rates, the number of stroke survivors who are non-institutionalized increased from 2.0 to 2.4 million between 1980 and 1991.  
    • Between 1980 and 2000, stroke mortality rates fell from 96.2 to 60.8 per 100,000 persons.  
    • A blood thinning drug was found to reduce the risk of heart attack, stroke, and cardiovascular disease by 20% in patients with acute coronary syndrome when given in addition to…  
    • Statin treatment soon after an acute heart attack reduces the risk of fatal heart disease or a recurrent heart attack by 24%.  
    • Primary angioplasty reduces 30-day mortality risk by 34% to 50%.  
    • Glycoprotein inhibitors have been shown to reduce the risk of death, a second heart attack, or the need for revascularization by 48% to 52% in patients who have suffered a…  
    • “Sherri Selph was 41 when she was first diagnosed with second-stage congestive heart failure. However, her rapidly diminishing health led to a diagnosis of end-stage heart disease. A heart transplant…