Under Affordable Care Act, Americans have had more preventive care for heart health

November 22, 2017

By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health, a UCLA study found. Comparing figures from 2006 through 2013, researchers found that more people were screened for diabetes, high cholesterol, cigarette use and high blood pressure -- all risk factors for heart disease -- after the ACA was implemented than before.

But the research, published in the peer-reviewed American Journal of Managed Care, also revealed a disparity between men and women in one key area. Although more men who are at risk for heart attacks and stroke take daily doses of baby aspirin, the number of women taking baby aspirin each day is unchanged since before the ACA became law. Baby aspirin is commonly prescribed to people at risk for heart attack and stroke. "There has been a lot of concern about women receiving poorer quality cardiovascular care, and our study reinforces this concern," said Dr. Joseph Ladapo, the study's lead author and an associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

Both before and since the ACA was enacted, baby aspirin was listed as a medication in about 9.5 percent of office visits by women 55 to 79, even though it is recommended for most people in that age range because of the increased risk for heart attack and stroke. At the same time, the number of office visits by men with baby aspirin listed as a medication increased to 13.5 percent from 11.1 percent. Ladapo said the discrepancy could be due to a lingering perception among some doctors that heart disease is more of a "man's disease."

The research found that from 2006 to the fourth quarter of 2013, the percentage of doctor visits during which diabetes screening was performed increased to 7.6 percent from 3.9 percent; during which people talked to their doctors about smoking, to 74.5 percent from 64.4 percent; and during which screening for high blood pressure, or hypertension, was performed to 76.4 percent from 73.2 percent.

The finding that more people are being screened for hypertension is particularly timely. The American Heart Association this month announced new guidelines for hypertension, effectively expanding the number of people who are considered to have high blood pressure.

"These findings provide people with more information to make a judgment about the value of the ACA," Ladapo said. "All of these preventive cardiovascular services that increased in frequency are recommended by the U.S. Preventive Services Task Force, and they all improve people's health." (The USPSTF is an independent panel of experts in disease prevention and primary care.)

Data for the study was drawn from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data from 2006 to 2013.

Among the study's limitations are that the researchers could not account for grandfathered health insurance plans that were exempt from some ACA provisions or whether patients or physicians were aware of those provisions. In addition, insurance plans with high deductible payments may have prevented some patients from visiting their physicians for cardiovascular care, which could have skewed some of the data.
-end-
The study's co-author is Dr. Dave Chokshi of New York University. The research was funded by a K23 Career Development Award from the National Heart, Lung and Blood Institute, and by grants from the National Institute on Minority Health and Health Disparities, and the Robert Wood Johnson Foundation.

Learn more about the cardiovascular research theme at UCLA.

Media Contact:
Enrique Rivero
310-267-7120
erivero@mednet.ucla.edu

University of California - Los Angeles Health Sciences

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.