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[Cardiovascular diseases in Switzerland - Prevalence and care]
Thomas Rosemann1, Agnès Bachofner2, Oliver Strehle3
1Universitätsspital Zürich, Institut für Hausarztmedizin, Pestalozzistrasse 24, 8091 Zürich.
Insights
Cardiovascular diseases (CVD) are a major health issue in Switzerland, causing significant mortality and economic costs. Improving the control of risk factors like hypertension and obesity through prevention is crucial to reduce disease burden.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Cardiovascular diseases (CVD) are a leading cause of death and hospitalization in Switzerland, despite advanced emergency care.
- A significant evidence-practice gap exists in managing CVD risk factors, with high percentages of uncontrolled hypertension, high LDL cholesterol, and diabetes.
- Prevalence of smoking, obesity, and sedentary lifestyles further exacerbates the CVD burden in Switzerland.
Purpose of the Study:
- To highlight the substantial morbidity and mortality associated with CVD in Switzerland.
- To quantify the economic impact of CVD, including disability-adjusted life years (DALYs) and healthcare costs.
- To emphasize the potential of primary and secondary prevention strategies in mitigating CVD outcomes.
Main Methods:
- Analysis of hospitalization and mortality data for cardiovascular diseases in Switzerland.
- Assessment of the prevalence of key cardiovascular risk factors (hypertension, hyperlipidemia, diabetes, smoking, obesity, physical inactivity).
- Calculation of disability-adjusted life years (DALYs) lost due to CVD risk factors and estimation of associated socioeconomic costs.
Main Results:
- Cardiovascular diseases accounted for 19,600 deaths and 133,000 hospitalizations in Switzerland in 2021.
- High rates of uncontrolled risk factors were observed: 55% for hypertension, 81% for high LDL cholesterol, and 44% for diabetes.
- CVD risk factors resulted in 311,332 DALYs lost, with significant contributions from hyperlipidemia (64,445 DALYs) and smoking (47,639 DALYs).
Conclusions:
- Suboptimal control of cardiovascular risk factors in Switzerland leads to preventable morbidity, mortality, and substantial economic costs.
- Primary and secondary prevention strategies offer a critical opportunity to reduce the burden of cardiovascular diseases.
- Addressing modifiable risk factors is essential for improving public health and reducing the significant healthcare costs associated with cardiovascular diseases.
Introduction:
Cardiovascular diseases (CVD) represent a significant health problem worldwide and in Switzerland. Despite preventive measures and advances in treatment, cardiovascular diseases still lead to a significant number of hospitalizations in Switzerland (133 000 in 2021) and are for responsible for almost 1/3 of all deaths (19 600 in 2021). Emergency care for acute cardiovascular events now has a very high standard in Switzerland compared to other countries. However, there is a large discrepancy between evidence and daily practice (evidence-performance gap) in cardiovascular risk factor control, because a large percentage of patients do not achieve the goals of the guideline recommendations: 55% of hypertensives, 81% of patients with elevated LDL cholesterol and 44% of diabetics. In addition, 21% of people in Switzerland currently smoke, 42% are considered obese and 24% of people are sedentary. Therefore, primary and secondary prevention offers great potential for reducing the morbidity and mortality of cardiovascular diseases. Sub-optimal control of cardiovascular risk factors leads to preventable cardiovascular events and associated economic costs. Thus, cardiovascular diseases not only affect life expectancy, but also influence the years with reduced quality of life (disability-adjusted life years, DALY). In Switzerland, the main risk factors of cardiovascular diseases lead to a loss of 311 332 DALYs in total, 45 454 DALYs lost by hypertension, 64 445 DALYs lost due to hyperlipidema, 24 283 DALYs due to diabetes mellitus, 47 639 DALYs due to smoking, 21 170 DALYs lost by obesity)and 4 669 DALYs lost due to a lack of exercise. Assuming that one DALY is associated with a socioeconomic burden of CHF 99 417, the total socioeconomic cost of all cardiovascular diseases is 4% of gross domestic product (GDP). Furthermore, cardiovascular diseases caused a cost burden of CHF 27,8 billion in direct and indirect healthcare costs in 2021. Keywords: Cardiovascular diseases, hypertension, risk factors, prevention, healthcare costs, DALY, mortality.
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