Tuesday, September 15, 2009

The American Risk Pool & Heart Disease

Excellent summary of the challenges our nation faces in bending the health care cost curve down.

Fewer and fewer Americans are at low risk for cardiovascular disease, according to an important and frightening new report on long term trends from the National Health and Nutrition Examination Surveys (NHANES) of adults 25-74 years of age.

In the most recent survey (1999-2004) only about 8% of US adults had a low risk profile, despite favorable trends in reducing smoking and cutting cholesterol. The overall increase in risk was due to the increased prevalence of diabetes, obesity, and hypertension, said the CDC’s Earl Ford, and his colleagues, in their report in Circulation.
Of major concern, the long term trend observed by the study was troubling. Following the early 1970s, when very few people had low risk factor profiles, progress appeared to be made, as the survey found substantial increases in the proportion of people with low risk profiles in the late 1980s and early 1990s. But then the hopeful trend reversed in the mid 1990s, apparently in accord with the increase in obesity and diabetes
Low risk was defined as;
•not currently smoking

•total cholesterol <200 mg/dL and not using cholesterol-lowering drugs

•blood pressure <120/80 mm Hg and not using antihypertensive drugs

•BMI <25 kg/m²

•no previous diagnosis of diabetese

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