Despite decades of progress in research and delivery of care, cardiovascular diseases continue to impose a heavy burden on our nation, even though the disease is manifesting later in life. These conditions cost the United States an estimated $555 billion in 2016 in healthcare expenses and lost productivity, and by 2035 the cost will skyrocket to $1.1 trillion annually.
Image
And there is an even greater cost: Heart disease is still the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC), causing one in every four deaths. By 2035, nearly half of the US population will have some form of cardiovascular disease.
We have a long way to go to reduce the burden of these diseases. There is a great need—and many opportunities—to enhance care as we strive to improve health and healthcare through a patient-centered healthcare system that provides value to all.
Groundbreaking Research
PCORI and the American Heart Association each support groundbreaking research that improves treatment for heart disease, stroke, and vascular diseases. In recent years, we have worked together in planning and funding research with a precision medicine approach that takes into account individual characteristics and allows patients the opportunity to provide input regarding their care and treatment options. We share a passion for finding out what will work best for individual patients based on their specific needs and personal preferences.
PCORI and the American Heart Association are partnering on projects to improve outcomes for patients with heart disease.
This week, we jointly hosted a briefing in Washington, DC, on the need to create evidence-based strategies for better prevention and treatment of cardiovascular disease. We also shared leading research from our partnership. We are jointly committed to research that provides information to help patients make informed choices about their individualized care options. One promising area for heart attack prevention discussed at the briefing was the reach and convenience that telehealth offers to help people with hypertension lower their blood pressure.
The PCORI-funded study based at HealthPartners Institute is researching the effectiveness of home blood pressure telemonitoring and home-based telehealth care coordinated by a clinical pharmacist or nurse practitioner over clinic-based care. Patients contributed extensively to planning the study and selecting its primary outcomes.
Addressing the Most Common Heart Abnormality
The conversation also highlighted how PCORI and the heart association are jointly funding the study to improve the treatment of atrial fibrillation. Often called AFib, it is today the most common heart abnormality in the United States. As many as 5.2 million Americans had AFib in 2015. We expect this figure to increase to 7.2 million by 2035 and cost an estimated $65 billion annually in direct medical and indirect costs.
PCORI and the association are together supporting the formation of a new research center—the Decision-Making and Choices to Inform Dialogue and Empower AFib Patients (DECIDE) Center—which will develop or adapt and then test the effectiveness of shared decision making tools focused on AFib.
Shared decision making tools help clinicians provide patients with information about diagnostic or treatment options, including potential benefits and harms, in a form they can more easily use and understand. These tools allow the clinician and patient to decide together which care plan makes the most sense given the patient’s preferences.
At the Start of a Journey
PCORI is engaged in more than 50 additional studies focused on improving care for individuals with cardiovascular disease and stroke. For example, in a PCORI-supported study now under way, researchers are aiming to improve outcomes for patients with acute heart failure who visit emergency departments.
The study is comparing the effectiveness of the association’s quality improvement program, Get with the Guidelines—Heart Failure, in an emergency department versus standard discharge. The goal is to reduce hospital readmissions and cardiovascular deaths among people with low incomes and in racial and ethnic minorities.
We are just beginning our journey to create patient-centered solutions to improve health outcomes and quality of life for people with cardiovascular diseases. There is a lot of work—and there are more research opportunities—ahead to combat the most common killer in the United States.
