Estimating the future burden of cardiovascular disease and the value of lipid and blood pressure control therapies in China

被引:174
作者
Stevens, Warren [1 ]
Peneva, Desi [2 ]
Li, Jim Z. [3 ]
Liu, Larry Z. [4 ]
Liu, Gordon [5 ]
Gao, Runlin [6 ,7 ]
Lakdawalla, Darius N. [8 ]
机构
[1] Precis Hlth Econ, Oakland, CA USA
[2] Precis Hlth Econ, Los Angeles, CA USA
[3] Pfizer Inc, San Diego, CA USA
[4] Cornell Univ, Weill Med Coll, New York, NY 10021 USA
[5] Peking Univ, Natl Sch Dev, Beijing 100871, Peoples R China
[6] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fu Wai Hosp, Beijing 100730, Peoples R China
[7] Peking Union Med Coll, Beijing 100021, Peoples R China
[8] Univ So Calif, Los Angeles, CA USA
关键词
Cardiovascular disease; Social value; Epidemiology; Lipids; Blood pressure; China; CORONARY-HEART-DISEASE; SECONDARY PREVENTION PROGRAMS; COST-EFFECTIVENESS; STATIN THERAPY; GLOBAL BURDEN; RANDOMIZED-TRIALS; VASCULAR-DISEASE; MIDDLE-INCOME; HEALTH; RISK;
D O I
10.1186/s12913-016-1420-8
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
Background: Lifestyle and dietary changes reflect an ongoing epidemiological transition in China, with cardiovascular disease (CVD) playing an ever-increasing role in China's disease burden. This study assessed the burden of CVD and the potential value of lipid and blood pressure control strategies in China. Methods: We estimated the likely burden of CVD between 2016 and 2030 and how expanded use of lipid lowering and blood pressure control medication would impact that burden in the next 15 years. Accounting for the costs of drug use, we assessed the net social value of a policy that expands the utilization of lipid and blood pressure lowering therapies in China. Results: Rises in prevalence of CVD risk and population aging would likely increase the incidence of acute myocardial infarctions (AMIs) by 75 million and strokes by 118 million, while the number of CVD deaths would rise by 39 million in total between 2016 and 2030. Universal treatment of hypertension and dyslipidemia patients with lipid and blood pressure lowering therapies could avert between 10 and 20 million AMIs, between 8 and 30 million strokes, and between 3 and 10 million CVD deaths during the 2016-2030 period, producing a positive social value net of health care costs as high as $932 billion. Conclusions: In light of its aging population and epidemiological transition, China faces near-certain increases in CVD morbidity and mortality. Preventative measures such as effective lipid and blood pressure management may reduce CVD burden substantially and provide large social value. While the Chinese government is implementing more systematic approaches to health care delivery, prevention of CVD should be high on the agenda.
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页数:10
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