Economic Impact of Moderate-Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey.
Physical activity (PA) has an established favorable impact on cardiovascular disease (CVD) outcomes and quality of life. In this study, we aimed to estimate the economic effect of moderate-vigorous PA on medical expenditures and utilization from a nationally representative cohort with and without CVD.



The 2012 Medical Expenditure Panel Survey data were analyzed. Our study population was limited to noninstitutionalized US adults ≥18 years of age. Variables of interest included CVD (coronary artery disease, stroke, heart failure, dysrhythmias, or peripheral artery disease) and cardiovascular modifiable risk factors (CRFs; hypertension, diabetes mellitus, hypercholesterolemia, smoking, and/or obesity). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures per capita. The final study sample included 26 239 surveyed individuals. Overall, 47% engaged in moderate-vigorous PA ≥30 minutes, ≥5 days/week, translating to 111.5 million adults in the United States stratifying by CVD status; 32% reported moderate-vigorous PA among those with CVD versus 49% without CVD. Generally, participants reporting moderate-vigorous PA incurred significantly lower health care expenditures and resource utilization, displaying a step-wise lower total annual health care expenditure as moving from CVD to non-CVD (and each CRF category).



Moderate-vigorous PA ≥30 minutes, ≥5 days/week is associated with significantly lower health care spending and resource utilization among individuals with and without established CVD.
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
Javier
J
Valero-Elizondo
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
Joseph A
JA
Salami
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
Chukwuemeka U
CU
Osondu
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
Oluseye
O
Ogunmoroti
Department of Health Policy and Management, Robert Stempel College of Public Health, Florida International University, Miami, FL.
Alejandro
A
Arrieta
Section of Cardiovascular Medicine, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, Yale University, New Haven, CT.
Erica S
ES
Spatz
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
Adnan
A
Younus
Division of Cardiology and Division of Research, Kaiser Permanente Northern California, Oakland, CA Department of Medicine, University of California San Francisco, San Francisco, CA.
Jamal S
JS
Rana
Section of Cardiology, Baylor College of Medicine, Houston, TX.
Salim S
SS
Virani
Non-Invasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, MA.
Ron
R
Blankstein
The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD.
Michael J
MJ
Blaha
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL Department of Medicine, School of Medicine, Emory University, Atlanta, GA.
Emir
E
Veledar
Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD khurramn@baptisthealth.net.
Khurram
K
Nasir
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000191:economics / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000191:economics / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006333:Heart Failure / Q000191:economics / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000191:economics / Q000453:epidemiology; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000191:economics / Q000453:epidemiology; D014481:United States; D055815:Young Adult
cardiovascular disease; cost; exercise; risk factors