Table 3

Predicted Lifetime Health and Cost Outcomes of CVD Clinical Preventive Services in US Population Groups

Preventive Service	US Adults	Men			Women

		Non-Hispanic White	Non-Hispanic Black	Hispanic	Non-Hispanic White	Non-Hispanic Black	Hispanic
Aspirin for primary prevention
Health impact, QALY	2,200	2,700	6,800	2,300	300	5,000	100
Cost-effectiveness, $	31 saved pp	50 saved pp	166 saved pp	47 saved pp	16,700/QALY	14 saved pp	60,200/QALY
CVD events, No.	−530	−750	−2,030	−840	−20	−530	−20
MI events	−300	−470	−930	−530	−20	−190	−10
Stroke events	−100	−110	−420	−110	Longevity^a	−240	−10
CVD deaths	−80	−110	−340	−150	−10	−100	−10
CRC cases, No.	−280	−370	−860	−390	−80	−370	−20
Persons treated for primary prevention, No.	15,600	22,000	39,200	27,500	2,300	21,000	2,200
Total costs, $ million	−3.1	−5.0	−16.6	−4.7	0.8	−1.4	1.1
Disease costs	−5.5	−7.9	−21.7	−8.3	−0.3	−4.8	−0.2
Screening costs	1.1	1.1	1.1	1.3	0.8	1.1	1.1
Treatment costs	1.4	1.8	4.0	2.3	0.2	2.3	0.2
Cholesterol screening
Health impact, QALY	14,300	17,500	25,600	19,700	7,900	14,200	9,100
Cost-effectiveness, $/QALY	33,800	29,400	22,900	25,600	56,500	42,100	48,900
CVD events, No.	−3,960	−5,090	−6,630	−5,320	−2,150	−3,520	−2,940
MI events	−1,500	−2,150	−2,860	−2,070	−700	−960	−930
Stroke events	−40	−150	Longevity^a	−40	Longevity^a	−130	−20
CVD deaths	−1,010	−1,120	−1,450	−1,220	−820	−1,120	−630
Persons treated for primary prevention, No.	40,100	43,300	51,400	45,500	32,500	43,100	36,000
Total costs, $ million	80.1	89.0	106.4	90.1	61.3	90.9	65.1
Disease costs	−36.3	−51.5	−76.4	−58.8	−12.1	−22.6	−21.9
Screening costs	16.1	17.7	18.6	18.5	13.1	18.2	14.4
Treatment and management costs	100.3	122.8	164.3	130.3	60.2	95.4	72.5
Hypertension screening
Health impact, QALY	15,600	11,800	17,000	14,900	16,500	24,700	16,300
Cost-effectiveness, $/QALY	48,500	52,200	60,600	40,800	48,300	42,100	49,500
CVD events, No.	−4,000	−3,460	−3,740	−4,060	−3,920	−5,930	−4,610
MI events	−750	−880	−970	−860	−600	−630	−690
Stroke events	−1,020	−680	−860	−720	−1,100	−2,250	−1,180
CVD deaths	−1,010	−780	−1,080	−1,040	−1,070	−1,480	−1,080
Persons treated for primary prevention, No.	53,400	46,200	58,900	47,900	56,700	64,700	59,000
Total costs, $ million	122.9	105.7	184.6	102.7	119.7	176.4	121.6
Disease costs	−34.8	−33.6	−37.5	−31.6	−30.7	−58.2	−38.0
Screening costs	33.8	34.2	27.4	34.4	35.4	28.8	34.9
Treatment and management costs	124.0	105.1	194.7	99.9	115.0	205.9	124.8

CRC = colorectal cancer; CVD = cardiovascular disease; MI = myocardial infarction; pp = per person; QALY = quality-adjusted life year.
Note: All outcomes are standardized for comparison purposes to reflect the lifetime of a 100,000 person US-representative birth cohort within each respective group starting at age 18 years. Cost-effectiveness is expressed in terms of incremental costs per QALY, unless a preventive service is cost-saving overall, in which case, it is expressed in terms of costs saved per person. All costs are expressed in 2012 US dollars.
↵a Population rates in the outcome are projected to stay the same or increase slightly due to increases in life expectancy attributable to the clinical preventive service.