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Rapid response to:

Research

Effectiveness and cost effectiveness of cardiovascular disease prevention in whole populations: modelling study

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4044 (Published 28 July 2011) Cite this as: BMJ 2011;343:d4044

Rapid Response:

Cardiovascular disease prevention may increase health care and other costs

Barton and colleagues 1,2 in their articles on cardiovascular disease
prevention display a table claiming that 4 interventions (cholesterol
reduction of 5%, systolic blood pressure reduction of 5%, salt intake
reduction of 3g daily, and eradication of trans fat) have the potential to
produce annual UK health savings of ?460,000 per year. A moment's
reflection suggests that this claim is overoptimistic. The beneficiaries
may live longer lives, but not in a state of perfect health and they do
not become immortal. They will all die of something, months or years
later, most likely from cardiovascular disease itself - the medical costs
are postponed, not "saved". During this added period of life, the
beneficiaries will have time to consume expensive medical and social
care, quite apart from drawing the state pension, supplementary benefits,
and occupational pensions. The authors' analysis leaves out these
additional costs. We rightly value health and longevity, but they are
expensive.

Peter Noble, MD, FRCP, FRCPsych

Emeritus Consultant, Bethlem Royal and Maudsley Hospitals, London

1. Barton P, Andronis L, Briggs A, McPherson K, Capewell S.
Effectiveness and cost effectiveness of cardiovascular disease prevention
in whole populations: modelling study. BMJ 2011; 343: d4044 doi:
10.1136/bmj. d44044

2. Barton P, Andronis L, Briggs A, McPherson K, Capewell S.
Effectiveness and cost effectiveness of cardiovascular disease prevention
in whole populations:modelling study. BMJ 2011; 343: d4044

Contact details
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Competing interests: No competing interests

17 August 2011
Peter J Noble
psychiatrist
Emeritus Consultant, Bethlem Royal and Maudsley Hospitals, London