Economic Impact of Moderate-Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey

J Am Heart Assoc. 2016 Sep 7;5(9):e003614. doi: 10.1161/JAHA.116.003614.


Background: 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.

Methods and results: 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).

Conclusions: 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.

Keywords: cardiovascular disease; cost; exercise; risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arrhythmias, Cardiac / economics
  • Arrhythmias, Cardiac / epidemiology
  • Cardiovascular Diseases / economics*
  • Cardiovascular Diseases / epidemiology
  • Case-Control Studies
  • Coronary Artery Disease / economics
  • Coronary Artery Disease / epidemiology
  • Diabetes Mellitus / epidemiology
  • Exercise*
  • Female
  • Health Expenditures*
  • Health Services / economics*
  • Health Services / statistics & numerical data
  • Heart Failure / economics
  • Heart Failure / epidemiology
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Peripheral Arterial Disease / economics
  • Peripheral Arterial Disease / epidemiology
  • Retrospective Studies
  • Smoking / epidemiology
  • Stroke / economics
  • Stroke / epidemiology
  • United States
  • Young Adult