The results suggest that treating chest pain associated with clogged arteries, known in medical terms as coronary artery disease (CAD), is the major driver of treatment costs for women with heart disease.
"Lifetime health care costs can reach $1 million for each woman with heart disease in this country," says researcher Leslee J. Shaw, Ph.D., of the division of cardiology at Cedars-Sinai Medical Center in Los Angeles, in a news release. "The societal burden for coronary artery disease for women with chest pain is expensive and could be responsible for a sizeable portion of U.S. health care costs."
Treating Women's Hearts Adds Up
In the study, published in Circulation: Journal of the American Heart Association, researchers followed 883 women who had been referred for a coronary angiogram, a procedure that uses a catheter to deliver dye into the coronary arteries which supply the heart muscle. A specialized X-ray examination of the coronary arteries can then detect for clogged arteries.
When someone is suspected to have CAD, such as a person who is experiencing chest pain or angina, a coronary angiogram can be done to evaluate for blockage.
The results of the study showed that 62 percent of the women had "nonobstructive" coronary artery disease or blockage of less than 50 percent of the artery; 38 percent of the women had one to three coronary arteries with blockage or narrowing.
"Almost two-thirds of these women had heart disease, but it was nonobstructive — there was no lesion or blockage, no significant narrowing of the vessels, nothing to be considered high risk. So we assumed that these women would not have as many health care needs as those with blockage of one, two or three, blood vessels," says Shaw. "But we found that the key factor was ongoing angina — the chest pain or discomfort that occurs when your heart doesn't get as much blood and oxygen as it needs. It was a very prominent driver of the need for clinical care, outpatient therapy, hospitalization, and drug therapies."
For example, within the first year of the study, the number of repeat angiograms or hospitalizations was nearly twice as high in women with nonobstructive CAD as those with one blocked artery.
In addition, the cost of drug treatment was highest among women with nonobstructive CAD. The cost of drugs, including those to treat high blood pressure and diabetes related to CAD accounted for nearly a third of total costs for these women.
Overall, 20 percent of women with nonobstructive disease and up to 55% of women with three blocked arteries were hospitalized for chest pain within five years.
The total lifetime treatment cost estimate for women with nonobstructive CAD was estimated at $767,288 and more than $1 million for those with one or more blocked arteries. Those estimates include the cost of medical care, indirect costs (such as lost hours from work) and out-of-pocket costs for drugs, medical devices, and alternative therapies.
SOURCES: Shaw, L. Circulation: Journal of the American Heart Association, Aug. 22, 2006; rapid access edition: vol. 114. News release, American Heart Association.
By Jennifer Warner
Reviewed by Louise Chang, M.D.
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