The Health Section

The forgotten killer: Cardiovascular disease

The number of people in the world dying from cardiovascular disease (CVD) continues to rise. Aetna International is taking a continuous, proactive approach to help address the issue. Helping people focus on staying healthy and providing support to those at-risk of developing CVD can help improve people’s ability to avoid CVD and additional complications.

Between 1930 and 2013, CVD deaths increased by 41 percent, according to the Global Burden of Disease Study 2013. In a white paper called, “The forgotten killer: Cardiovascular disease,” experts at Aetna International argue for the need to focus on health at a population level to address the disease.

While genetics plays a role in whether or not people develop CVD, experts at Aetna International argue that it is the result of lifestyle choices that over time have a devastating cumulative effect. In addition, preventing CVD is not quite as simple as just seeing a doctor. It also requires lifestyle changes, an awareness of risk factors, access to adequate health care and often ongoing coaching and support.

“One way to think about CVD is to picture an onion. The outermost layer represents the most visible outcomes of CVD, primarily heart attack and stroke. Peel back that layer, and you find coronary heart disease, cerebrovascular disease and the other diseases and conditions that lead to those outcomes. But those diseases and conditions are not the core of the onion. Remove another layer, and you find conditions like obesity, diabetes, clogged arteries and hypertension (high blood pressure) which contribute to them. Finally, peel back that layer, and you get to the key root causes of CVD: lifestyle choices that contribute to those conditions,” says Dr. Stella George, Senior Medical Director, Aetna International.

The prevalence of CVD among Aetna International customers continues to increase globally each year. Between 2014 and 2016, expatriates in the Middle East and Africa regions showed the highest prevalence of cardiovascular disease at 9.9 percent. Expatriates in the Asia Pacific and in Europe regions had a lower prevalence of cardiovascular disease at 4.43 percent and 5.35 percent, respectively. To address such health care trends, Aetna International has launched a number of clinical initiatives in recent years to help customers receive the care they need to help them become and stay healthy.

“We believe the best way to support our customers with their health and wellness needs is to take a continuous, proactive approach – not one that is episodic and reactive. So we are transforming our health insurance model into a health and wellness ecosystem that helps people focus on being and staying well,” the authors wrote in the white paper. “We engage with at-risk individuals to prevent the onset of disease and help people to keep healthy, and we offer those living with worsening and chronic conditions a wide range of care programs to help prevent further deterioration.”

The organization’s In Touch Care model, which launched in 2016 and gives at-risk customers direct one-on-one access to a clinician, has seen customer engagement and treatment adherence increase by 73 percent and 12.5 percent, respectively. In 2016, customers in the Middle East, who showed indications of ischemic heart disease, enrolled in a 90-day text messaging support program – part of the In Touch Care model. Those customers visited specialists more, which resulted in 22 percent lower health care costs. The program resulted in a 5.5 percent decrease in heart attacks compared to non-enrolled customers.

The experts at Aetna International also argue the importance and need for improved access to care. The World Health Organization states two-thirds of countries have evidence-based national care standards but that barely half implement those standards. In some areas of the world, essential technology and basic medications to treat cardiovascular disease are not available in hospitals, health centers and community hospitals. Aetna International is working with government health systems and organizations with large populations to set up or enhance the building blocks needed to create successful primary care models.

“Our goal is to help our clients get the data and implementable strategy support they need to manage the health of their populations,” the authors wrote.

Earlier this year, Aetna International launched a virtual health care service – known as vHealth – to better serve its customers. The service makes it easier and more convenient for people to access quality, impartial primary health care advice and helps them to receive treatment wherever they are in the world.

For more information, visit www.aetnainternational.com