Nutrition and Coronary Heart Disease
2 Previousceaonnutritioninterventions
A number of previous cost-effectiveness analyses examined the effects of promoting
nutrition in the prevention of CHD. Weinstein and Stason (1985) examined the cost-
effectiveness of selected interventions to treat or prevent CHD using US data. Hall et al
(1988) compared alternative strategies for the prevention of CHD. Kritiansen, Eggen
and Thelle (1991) looked at the cost-effectiveness of programs aimed at lowering serum
cholesterol in Norwegian males. And finally, Crowley, Dunt and Day (1995) assessed
the cost-effectiveness of both treatment and prevention of CHD in Australia. In this
section each of these papers are examined individually, with special focus on the
methodology used and the conclusions drawn.
Weinstein and Stason (1985)
The aim of the paper by Weinstein and Stason (1985) was to bring together a number of
other cost-effectiveness studies on therapeutic and preventive programs in the area
related to CHD. This is because a cost-effectiveness ratio is of little use unless one has
something to compare it with. The preventive measures they examined were detection
and management Ofhypertension and hypercholesterolemia. These were in addition to
the therapeutic measures of coronary artery bypass surgery, beta-blocking drugs,
coronary care units and emergency services programs
Weinstein and Stason (1985) noted that up to one in three American adults could be
labelled as hypertensive. At the time of writing, Weinstein and Stason (1985) stated
that even though the increased risk of CHD resulting from even mildly elevated blood
pressure has been well documented, the effectiveness of preventive treatment remains
uncertain. Further, if drug therapy were used for all hypertensive people the cost would
be in a multi-million dollar dimension.
The cost-effectiveness analysis Ofhypertension was based on results from the
Framingham study (Weintsein and Stason, 1976). From this study, Weinstein and
Stason (1985) concluded that even though anti-hypertensive treatment of moderate and
mild hypertension leads to a significant reduction in the future medical costs, the
program had to be justified through increased quality and length of life.
CHERE Project Report 11 - November 1999