USING SIMULATION MODELING TO COMPARE ALTERNATIVE LIFESTYLE APPROACHES AND PREVENT CARDIOVASCULAR DISEASE
Candidate for the Lee B. Lusted Student Prize Competition
USING SIMULATION MODELING TO COMPARE ALTERNATIVE LIFESTYLE APPROACHES AND PREVENT CARDIOVASCULAR DISEASE
Purpose: Recognizing the importance of cardiovascular disease (CVD) prevention, the American Heart Association (AHA) has emphasized the need to promote ideal lifestyles and documented alternative approaches in its 2020 Impact Goals. Our objective was to use a validated agent-based simulation model to evaluate and compare the effectiveness of several lifestyle modification approaches in preventing CVD over time.
Methods: We used the New York Academy of Medicine Cardiovascular Health Simulation (NYAM-CHS) Model to simulate CVD (including myocardial infarction and stroke) incidence for the general population and compared these results with the implementation of different lifestyle modification approaches over 5, 10, 15 and 20 years. The internal and external validity of the NYAM-CHS Model had been demonstrated in several previous studies. In this study, we compared a set of health outcomes for four hypothetical lifestyle modification programs ("quit smoking", "promote a healthy diet", "improve physical activity" and "reduce obesity") which were designed to reduce by half the proportion of the population who smokes, eats less than five fruits and vegetables/day, exercises less than 150 minutes/week and has a body mass index (BMI) of 25 or more, respectively. We estimated population demographics and health profiles for the general population of US adults from the 2007 Behavioral Risk Factor Surveillance System (BRFSS). We generated 10,000 persons and reported the reduced cases of CVD with the implementation of each of the four lifestyle programs as opposed to an alternative simulation without the implementation of the proposed programs.
Results: "Quit smoking" was the most effective lifestyle program and it prevented more than 40 cases of CVD over 15 and 20 years as opposed to the no intervention scenario. The other three programs were much less effective than "quit smoking." "Reduce obesity" was the most effective program after "quit smoking." "Promote a healthy diet" and "improve physical activity" were similar in their effectiveness in preventing CVD.
Conclusion: When considering the general US population of adults, the most effective lifestyle program in preventing CVD was "quit smoking" and the next was "reduce obesity." The results can provide valuable insights into how to select effective population-specific interventions without the need to spend substantial resources testing and implementing different programs in the field.
