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Published on: September 26, 2018

Rationale and public health implications of changing CHD risk factor definitions

Robert M Kaplan1, Michael Ong

  • 1Departments of Health Services and Medicine, University of California-Los Angeles, Los Angeles, CA 90095-1772, USA. rmkaplan@ucla.edu

Annual Review of Public Health
|January 16, 2007
PubMed

Insights

Lowered diagnostic thresholds for high blood pressure, high cholesterol, and impaired fasting glucose now classify most adults as having a chronic condition. This study examines the health and financial outcomes of these expanded disease definitions.

Area of Science:

  • Public Health
  • Medical Diagnostics
  • Health Policy

Background:

  • Disease definition and diagnostic guidelines are fundamental to medical practice and public health policy.
  • Recent years have seen lowered diagnostic thresholds for common conditions like high blood pressure, high cholesterol, and impaired fasting glucose.
  • These changes have led to a significant expansion of the healthcare market and reclassification of a large portion of the adult population.

Purpose of the Study:

  • To evaluate the health and financial outcomes associated with revised diagnostic thresholds for cardiovascular disease and stroke risk factors.
  • To assess the impact of updated guidelines for blood pressure, serum cholesterol, and fasting plasma glucose.
  • To provide estimates on the number of individuals affected, cost implications, and overall public health consequences.

Main Methods:

  • Analysis of health and financial outcomes related to changes in diagnostic thresholds.
  • Evaluation of guidelines for blood pressure, serum cholesterol, and fasting plasma glucose.
  • Estimation of affected populations, costs, and public health impacts.

Main Results:

  • Lowered diagnostic thresholds for high blood pressure, high cholesterol, and impaired fasting glucose result in a substantial increase in the number of adults requiring medical attention.
  • Under the latest proposed thresholds, a very high percentage of the adult population meets criteria for a chronic condition diagnosis.
  • Significant implications for healthcare utilization, costs, and public health are associated with these guideline changes.

Conclusions:

  • Changes in diagnostic thresholds significantly expand the definition of disease, impacting a large segment of the adult population.
  • The study highlights the need to carefully consider the health and financial consequences of evolving diagnostic criteria.
  • Further research is needed to fully understand the long-term public health impact of these broadened diagnostic definitions.

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