MMore than 184 million people – about 61% of U.S. adults – are likely to have some type of cardiovascular disease by 2050, according to the American Heart Association (AHA). reported earlier this month. This will lead to a tripling of heart disease-related costs. It’s a statistic that Alice Park, TIME’s senior health correspondent, cited to begin her discussion on the future of healthcare with AHA CEO Nancy Brown; cardiologist Kiran Musunuru; and Andres Acosta, associate professor of medicine at Mayo Clinic, for a TIME100 Health panel in New York on Tuesday.
The event was sponsored by the AHA and is part of the TIME100 Talks series. The TIME100 Health list includes the most influential people in the healthcare industry around the world.
Heart disease has been the top killer of Americans since 1950. Brown, who has been CEO of the AHA since 2008, said the number of people in the U.S. living with the risk of heart disease — and the resulting cost — is “staggering.” Part of the problem, she said, is the lack of equal access to health care and social determinants of health, such as healthy eating and a living wage. But another issue is how the US healthcare system addresses these types of medical conditions.
“I think this country focuses too much on treating disease,” Brown said. “But we are not focusing enough on prevention and helping people early in their lives understand the power of things that make a difference in their lives. You know, 80% of cardiovascular diseases are preventable.”
Musunuru, professor of cardiovascular medicine and genetics at the University of Pennsylvania’s Perelman School of Medicine, said cardiovascular disease can be attributed about half to genetics and about half to environment or lifestyle. There are ways to reduce risk factors for developing cardiovascular disease, such as cholesterol levels, blood pressure and even obesity. The challenge, he said, is that these risk factors develop over time. And the country’s current healthcare system tries to deal with chronic diseases through chronic treatment. While there may be merits to this approach, Musunuru said, it also places “an outsized burden” on patients.
He suggested that the healthcare system shift its focus to preventing chronic diseases, starting at an early age – like we do with vaccines to prevent infectious diseases.
“You’re not going to eliminate heart disease, but will you be able to prevent heart attacks and strokes for decades?” Musunuru said. “Instead of having a massive heart attack at age 60, and maybe dying from it, this happens at age 100 and you enjoy 40 years of life that you otherwise wouldn’t have.”
Acosta, who co-directs the Nutritional Obesity Research Program and directs the Mayo Clinic Obesity Precision Medicine Program, discussed how some treatments can also help reduce the risk of other diseases. Obesity, for example, is one of the leading risk factors for heart disease, and weight loss medications such as Wegovy and Zepbound are having a significant impact on treating the disease. AHA previously reported that people who took Wegovy decreased their risk of heart attack, stroke or death from cardiovascular problems by 20%, compared to those who took a placebo. Acosta said this data represents a “game changer” and marks a “new era” in the treatment of obesity and cardiovascular disease.
Panelists also highlighted the importance of genetic testing. Few people have their genetics tested, Brown said, and a priority for the AHA is to encourage people to do so.
Musunuru researches the genetics of heart disease and aims to identify genetic factors that protect against disease. Having genetic information, he said, can help doctors know early what patients’ risks are for developing certain diseases and can allow patients to take a “proactive” approach to their health.
“Your genes are the same the day you are born and the day you die,” Musunuru said. “If you know what’s in your genes at the time you’re born, that gives you a prediction of what your life will be like as it unfolds.”
TIME100 Talks: Reimagining the Future of Healthcare was presented by the American Heart Association.
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