3 Reasons Why Cardiovascular Costs Are Skyrocketing

What’s the leading cause of death among both men and women in the United States? Here’s a hint: It’s not cancer. Or accidents. Or diabetes. It’s cardiovascular disease—a group of conditions that claim one life every 33 seconds and cost the U.S. about $240 billion every year.

While cardiovascular disease (also referred to as heart disease) is already a major concern among cardiologists and people who want to live long and healthy lives, it’s also a growing focus area for employers. That’s not only because companies care about their workers and their well-being, but also because employers have to shoulder much of the costs associated with heart conditions, spending more than $210 billion on heart disease every year. And while that’s already an eye-popping number, it’s expected to double by 2035.

So what’s behind these escalating cardiovascular disease costs? And even more importantly, what can employers do about it?

Economic projections and future cost forecasts

The economic burden of cardiovascular disease in the U.S. is expected to rise sharply. Current estimates place annual costs at nearly $417.9 billion as of 2021, including direct medical expenses and indirect costs such as lost productivity. However, future projections warn that by 2034, these costs may nearly quadruple, reaching $1.49 trillion, largely driven by an aging population and increasing prevalence of risk factors like obesity and diabetes. Studies forecast that by 2050, U.S. cardiovascular disease costs could triple to over $1.8 trillion, underscoring the urgent need for enhanced prevention and cost management strategies.

3 reasons cardiovascular disease costs are skyrocketing

1. An increase in underlying risk factors

One key reason why cardiovascular disease costs so much is simply because it’s so prevalent. More cases mean more costs and, unfortunately, cardiovascular diseases are expected to continue to increase through the year 2060.

That’s because all of the major risk factors of heart disease continue to trend upward as well. According to the CDC, a few of the most common risk factors for cardiovascular disease are high blood pressure (hypertension), diabetes, and obesity. Studies show that each of these conditions has experienced a significant uptick in its own right:

• Nearly half of U.S. adults have hypertension and that percentage has been steadily rising over the past several decades.
• It’s projected that, between 2015 and 2030, the total number of people with type 2 or type 1 diabetes will increase by 54%.
• Obesity prevalence has consistently risen since 1999, with only a temporary pause between 2009 and 2012. By 2030, 78% of American adults are projected to be overweight or obese.

With those facts in mind, the equation becomes pretty straightforward: more people with risk factors means more people with heart disease which means more spending on cardiovascular conditions.

2. Overtreatment

Much of the treatment for heart disease hinges on individual lifestyle changes—committing to a healthy diet, exercising regularly, and quitting smoking. Those are all relatively low-cost and aren’t major contributors to skyrocketing cardiovascular spending.

However, people with more severe symptoms and conditions might require additional services and procedures. This is an area where overtreatment and, as a result, overspending can run rampant.

That’s especially true when looking at coronary stents. These are small, mesh tubes placed in the coronary arteries to keep them open and are one of the most popular treatments for heart disease. While this type of device can help treat unstable angina (chest pain without a known trigger that persists even when resting), it’s not as helpful for stable angina (chest pain with a trigger like stress or exercise that stops after a few minutes of rest).

Cardiovascular disease costs vary widely by specific conditions and interventions. Hospitalizations for heart failure, myocardial infarction, arrhythmias, and stroke represent the bulk of these expenses. For example, hospital stays for heart disease average about $21,000 per admission, with millions of such admissions annually. High-cost treatments like coronary stent placements, bypass surgeries, and implantable devices (pacemakers, defibrillators) further drive spending. Unfortunately, studies reveal up to 20% of certain procedures, including stent placements, may be unnecessary, resulting in billions of dollars of avoidable costs.

1 in 5 coronary stent placements were deemed unnecessary.

In fact, research shows that medications are just as effective as stents in reducing cardiac events and that stents are dramatically overused in modern medicine. According to one study, hospitals performed more than 229,000 unnecessary stent placements between 2019 and 2021—meaning 20% of the total stents placed were unnecessary.

Overtreatment isn’t just a medical problem—it’s a money problem too. Stents are expensive—Medicare, for example, wasted as much as $2.44 billion on unnecessary stents in those same years, further adding to the increasing cost of cardiovascular care and treatment.

3. An aging population 

There’s another major risk factor for cardiovascular disease: age. Much like every other part of the body, the heart changes with age. The muscles can degenerate and the valves can thicken, making people over the age of 65 far more likely than younger people to develop heart disease or experience other coronary events.

The population of the United States isn’t getting any younger. On the contrary, our population is older today than ever, with the median age increasing from 30.0 to 38.9 between 1980 and 2022. Estimates state that the number of adults aged 65 and older will increase an additional 44% from 2017 to 2030.

As the overall population gets older, there’s a far higher prevalence of heart disease and that translates to more money spent on combating those conditions.

Prevention and cost savings

Prevention is a cornerstone of managing cardiovascular costs. A combination of services such as risk assessment, cholesterol and blood pressure management, nutrition counseling, and fitness programs can demonstrate measurable benefits. These types of benefits can reduce hospital admissions and costly interventions by promoting healthier lifestyles and early problem detection. For employers and payers, investing in wellness offers a return on investment by reducing long-term healthcare utilization and enhancing employee productivity.

Lifestyle and preventive care impact

Adopting heart healthy lifestyle changes is among the most cost-efficient ways to combat cardiovascular disease. Regular exercise, nutritious diet, smoking cessation, and stress management can substantially reduce risk factors like hypertension and diabetes. These efforts decrease reliance on expensive medical procedures and hospitalizations. Integrating lifestyle change guidance with employer wellness initiatives and patient education empowers individuals and lowers system-wide spending.

Read how Carrum Health helped Stephanie get the heart surgery she badly needed.

Cardiovascular disease is a major burden not only for the people who need to grapple with these conditions but also for the entire healthcare system and employers who carry much of the cost associated with care and treatment.

However, both the prevalence and cost of heart disease are projected to continue to increase, which means employers will need to find ways to manage costs while still providing access to quality treatment. A centers of excellence program can help employers prioritize exceptional care for heart conditions while mitigating the financial burden.

Ultimately, all employees deserve accessible and affordable care, but their employers need to be able to afford it, too. That’s the heart of the matter.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.