Reductions in major cardiovascular risk factors accounted for 2,055,500 life-years gained, more than twice the 1,092,400 life-years gained from modern CHD treatments between 1980 and 2000.
Observational
Do modern treatments and changes in risk factor prevalence increase life expectancy in US adults?
Modest reductions in major cardiovascular risk factors accounted for more than twice as many life-years gained as did medical treatments, though gains were partially offset by rising obesity and diabetes.
Has the recent US decline in coronary heart disease (CHD) mortality increased life expectancy? The authors estimated the number of life-years gained from CHD treatments and changes in the prevalence of cardiovascular disease risk factors for the US population between 1980 and 2000. The previously validated IMPACT model was used to integrate data on numbers of CHD patients, treatment uptake, treatment effectiveness, population risk factor trends, and median survival among US adults. There were 308,900 fewer CHD deaths in 2000 among Americans aged 25-84 years than if 1980 mortality rates had applied. These 308,900 fewer deaths represented approximately 3,147,800 life-years gained (sensitivity analysis range, 2,448,900-3,744,900). Treatments for patients accounted for approximately 1,092,400 (751,700-1,387,000) life-years gained, whereas changes in the prevalence of population risk factors accounted for a gain of 2,055,500 (1,697,200-2,346,300) life-years. However, the 2,770,500 life-years gained through decreased levels of smoking, cholesterol, blood pressure, and physical inactivity were diminished by a loss of 715,000 life-years attributable to increased rates of obesity and diabetes. Therefore, modest reductions in the prevalence of several major cardiovascular disease risk factors accounted for more than twice as many life-years gained as did treatments. Unfortunately, these gains were partially offset by substantial increases in obesity and diabetes.
Capewell et al. (Thu,) conducted a observational in Coronary heart disease. CHD treatments and changes in cardiovascular disease risk factors vs. 1980 baseline mortality rates was evaluated on Life-years gained. Reductions in major cardiovascular risk factors accounted for 2,055,500 life-years gained, more than twice the 1,092,400 life-years gained from modern CHD treatments between 1980 and 2000.