Individuals with favorable cardiovascular (CV) health, (i.e. having ideal levels of all major cardiovascular risk factors, including blood pressure, cholesterol, body mass index, not smoking and no diagnosis of diabetes), during middle-age have been shown to have a lower lifetime risk for cardiovascular disease and a longer lifespan. Previous studies on the benefits of a having a favorable CV profile have examined outcomes such as morbidity and mortality separately. As yet, it remains unclear whether other morbid conditions simply replace CVD or whether individuals in favorable CV health actually experience an extension of healthy life (i.e. without major morbidity). While we know that favorable CV health delays the onset of cardiovascular disease and increases longevity, its impact on cumulative lifetime morbidity remains unknown. The over-arching goal of this proposal it to understand how favorable cardiovascular health at younger and middle ages may achieve the goal of prolonging the period of healthy life and reducing the lifetime burden of morbidity (from all major chronic diseases) at older age. To accomplish this aim we will take advantage of the current linkage of the Chicago Heart Detection Project in Industry Study (CHA;39,522 men and women screened in 1967-1973) with Medicare claims data through 2010, which will provide us with over 25 years of follow-up. We will then use sophisticated statistical methods to address the following specific aims.
Specific Aims : 1. To determine whether favorable cardiovascular health at younger and middle ages is associated with the compression of CVD morbidity into a shorter period of time before death and/or lower average level of CVD morbidity in older age 2. To determine whether favorable cardiovascular health at younger and middle ages is associated with the compression of morbidity into a shorter period of time before death and/or lower average level of morbidity (from all major chronic diseases) in older age 3. To determine whether favorable cardiovascular health during middle-age is associated with lower cumulative, annual, and end of life Medicare expenditures.
This proposal addresses clinically and socially meaningful questions about whether favorable CV health will prolong healthy lifespan or will simply prevent mortality at the cost of prolonging life lived with morbidity. Findings from this study will have a significant impact on health care policy and prevention, especially crucial during this era of risig healthcare costs.