Document Detail


The cost-effectiveness of exercise training for the primary and secondary prevention of cardiovascular disease.
MedLine Citation:
PMID:  10860196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although exercise training improves cardiovascular disease (CVD) risk factors, few studies have evaluated its potential long-term cost-effectiveness. METHODS: Using the Cardiovascular Disease Life Expectancy Model, a validated disease simulation model, we calculated the life expectancy of average 35- to 74-year-old Canadians found in the 1992 Canadian Heart Health Survey. The impacts of exercise training on cardiovascular risk factors were estimated as a 4% decrease in low-density lipoprotein (LDL) cholesterol, a 5% increase in high-density lipoprotein (HDL) cholesterol, and a 6 mm Hg decrease in both systolic and diastolic blood pressure. Exercise adherence was estimated at 50% for the first year and 30% for all additional years. Costs for a supervised exercise program determined from Canadian sources and converted to US dollars were estimated at $605 for the first year (medical evaluation, stress test, exercise prescription, and program costs) and $367 for all additional years (program costs). For an unsupervised program, the costs were estimated at $311 for the first year and $73 for all additional years. RESULTS: The cost-effectiveness (CE) of an unsupervised exercise program (1996 U.S. dollars) was less than $12,000 per year of life saved (YOLS) for all individuals. The CE of a supervised exercise program was less than $15,000/YOLS for men with CVD, and between $12,000 and $43,000 for women with CVD and men without CVD. CONCLUSIONS: Given the relatively few risks, substantial long-term benefits, and modest costs, an unsupervised exercise training program represents good value for all. A more expensive supervised exercise program is also cost-effective for most individuals with CVD.
Authors:
I Lowensteyn; L Coupal; H Zowall; S A Grover
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation     Volume:  20     ISSN:  0883-9212     ISO Abbreviation:  J Cardiopulm Rehabil     Publication Date:    2000 May-Jun
Date Detail:
Created Date:  2000-10-02     Completed Date:  2000-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511296     Medline TA:  J Cardiopulm Rehabil     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  147-55     Citation Subset:  IM    
Affiliation:
Centre for the Analysis of Cost-Effective Care, Montreal General Hospital, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Canada / epidemiology
Cardiovascular Diseases / economics*,  epidemiology,  etiology,  prevention & control*
Cost-Benefit Analysis
Exercise*
Female
Humans
Life Expectancy
Male
Middle Aged
Models, Cardiovascular
Primary Prevention / economics
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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