Study: The High Cost of Inaction: Continued tobacco use accelerates cardiovascular risk factors for people with peripheral artery disease

Monday, September 28, 2015

“Like adding gasoline to a fire.” This is how investigators from the University of Minnesota Medical School’s Cardiovascular Division describe the effect of continued tobacco use on the number of heart attacks, serious leg artery blockages, strokes, and aneurysms in people with peripheral artery disease (PAD). The new major research study was published online today in the Journal of the American College of Cardiology

The study analyzed 2011 claims data of more than 22,000 people with PAD, and was the first to define the associated immediate health and economic burden of tobacco use in Minnesota and the United States. Claims data used in the study were provided by Blue Cross and Blue Shield of Minnesota, the state’s largest health plan.

PAD, defined by leg artery blockages that occur as we age and are exposed to risk factors – is one of the most common cardiovascular diseases. PAD is now known as the “heart disease that strikes outside the heart.” The research clearly illustrates the devastating impact smoking can have for those dealing with this disease.

“Everyone knows tobacco hurts health, but until now no one has known how amazingly powerful this impact is. For people with PAD, smoking is especially bad: The health impact is ‘right now’ and the cost to the patient, society and health payers is gigantic,” said Sue Duval, Ph.D., lead author and associate professor of medicine and biostatistics in the Cardiovascular Division in the University of Minnesota Medical School. “This study represents one of the largest measurements of the impact of PAD on health, in our state and the nation. Because Minnesota is a state that is known to be “heart healthy,” the implications of this research, and the costs of smoking, are sure to be even higher around the country and the world.”

The study also found:

  • Over a short one year period, people with PAD who smoke suffered immense short term health risks.
  • Within one year, nearly half (49%) of tobacco users were hospitalized, a proportion 35 percent higher than non-tobacco users.
  • Individuals who smoked were much more frequently admitted to a hospital to treat leg artery blockages, heart disease, stroke, pneumonia and bronchitis.
  • The cost was – beyond the suffering of each patient – extremely expensive, costing on average $17,673 more in the first year compared to individuals who did not smoke.

“I have studied PAD for over two decades and these results startled me. It also stuns me that patients, families, health systems, and government – do not seem shocked. Preventable suffering continues every year,” said Alan T. Hirsch, M.D., senior author and professor of medicine, epidemiology and community health in the Cardiovascular Division in the University of Minnesota Medical School. “Tobacco use is to heart and vascular disease like gasoline thrown on a fire. We know that each full effort to help a person quit smoking costs less than $500. Compared to the nearly $18,000 per year in added health care costs, giving patients every tool to quit is the greatest health bargain around. We must treat the causes of disease, and not just the consequences. Our lives and pocket books depend on this radical change.”

The study was funded by the Vascular Medicine Program at the University of Minnesota. The study authors cite no conflicts of interest.