Relative Value of Clinical Preventive Services for CVD, by Outcome, for US Population Group
| Outcome | US Adults | Men | Women | ||||
|---|---|---|---|---|---|---|---|
| Non-Hispanic White | Non-Hispanic Black | Hispanic | Non-Hispanic White | Non-Hispanic Black | Hispanic | ||
| Largest health impact (QALY) | Hypertensiona (15,600) | Cholesterol (17,500) | Cholesterol (25,600) | Cholesterol (19,700) | Hypertension (16,500) | Hypertension (24,700) | Hypertension (16,300) |
| Cholesterolb (14,300) | Hypertension (11,800) | Hypertension (17,000) | Hypertension (14,900) | Cholesterol (7,900) | Cholesterol (14,200) | Cholesterol (9,100) | |
| Aspirinc (2,200) | Aspirin (2,700) | Aspirin (6,800) | Aspirin (2,300) | Aspirin (300) | Aspirin (5,000) | Aspirin (100) | |
| Highest cost-effectiveness ($ saved pp, or $ per QALY) | Aspirin (31 pp) | Aspirin (50 pp) | Aspirin (166 pp) | Aspirin (47 pp) | Aspirin (16,700/QALY) | Aspirin (14 pp) | Cholesterol (48,900/QALY) |
| Cholesterol (33,800/QALY) | Cholesterol (29,400/QALY) | Cholesterol (22,900/QALY) | Cholesterol (25,600/QALY) | Hypertension (48,300/QALY) | Cholesterol (42,100/QALY) | Hypertension (49,500/QALY) | |
| Hypertension (48,500/QALY) | Hypertension (52,200/QALY) | Hypertension (60,600/QALY) | Hypertension (40,800/QALY) | Cholesterol (56,500/QALY) | Hypertension (42,100/QALY) | Aspirin (60,200/QALY) | |
| Most prevented myocardial infarctions (No.) | Cholesterol (1,500) | Cholesterol (2,150) | Cholesterol (2,860) | Cholesterol (2,070) | Cholesterol (700) | Cholesterol (960) | Cholesterol (930) |
| Hypertension (750) | Hypertension (880) | Hypertension (970) | Hypertension (860) | Hypertension (600) | Hypertension (630) | Hypertension (690) | |
| Aspirin (300) | Aspirin (470) | Aspirin (930) | Aspirin (530) | Aspirin (20) | Aspirin (190) | Aspirin (10) | |
| Most prevented strokes (No.) | Hypertension (1,020) | Hypertension (680) | Hypertension (860) | Hypertension (720) | Hypertension (860) | Hypertension (2,250) | Hypertension (1,180) |
| Aspirin (100) | Cholesterol (150) | Aspirin (420) | Aspirin (110) | Aspirin (longevityd) | Aspirin (240) | Cholesterol (20) | |
| Cholesterol (40) | Aspirin (110) | Cholesterol (longevityd) | Cholesterol (40) | Cholesterol (longevityd) | Cholesterol (130) | Aspirin (10) | |
CVD = cardiovascular disease; pp = per person; QALY = quality-adjusted life year.
Note: Preventive services are aspirin counseling, hypertension screening, and cholesterol screening. All outcomes are for 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 expressed in 2012 US dollars.
↵a Hypertension screening and management in adults.
↵b Lipid disorder screening and management in adults.
↵c Aspirin for the primary prevention of cardiovascular disease and colorectal cancer.
↵d Population rates in the outcome are projected to stay the same or increase slightly because of increases in life expectancy attributable to the clinical preventive service.