Cost of obesity-based heart risk in the context of preventive and managed care decision making: An NHANES cross-sectional concurrent study

The American College of Cardiology's (ACC) 2013 standards of primary care were created to reduce individual heart risk (heart attack, stroke or cardiac death event within 10 and 30 years) and obesity-based chronic disease risk, but if taken together, may also represent modifiable lab/exam levels that are more predictive of cost than claims-based billing code sets.;The research question is, how does the relationship between obesity and heart risk impact total medical costs? A clinical data set, representative of US "well-appearing" and impaired obese and atherosclerotic cardiovascular disease (ASCVD) adults alike, was used to determine prevalence, cost differences, and correlates per stage. This cross-sectional study used a public health data set to investigate the relationship between obesity and heart risk and their impact on treatment costs with general linear models.;This study uses consecutive National Health and Nutrition Examination Surveys (NHANES) data from 2003-2012 to concurrently model obese body size (c.f., normal weight) main effects, moderated by non-diabetic moderate 10-year ASCVD risk (c.f., 30-year and diabetic), on total medical cost outcomes. Minors, seniors 76+, outlier diseases, and pregnant women were excluded, resulting in 192,447,424 weighted or 22,510 unweighted participants. Findings are that obesity explains 2% of cost by itself, together with heart risk some 10% contribution is explained, and interaction effects at 0.2% has the least potency on costs. Heart risk, 10-year and 30-year alike, exponentially compound costs at the onset of diabetes and heart attack/stroke; this means the speed of heart disease progression in patients differs but mean costs rise identically with new diabetes or heart events.