Abstract
BackgroundThe aim of this study was to examine the attribution of each cardiovascular risk factor in combination with abdominal obesity (AO) on Japanese health expenditures.MethodsThe health insurance claims of 43,469 National Health Insurance beneficiaries aged 40–75 years in Ibaraki, Japan, from the second cohort of the Ibaraki Prefectural Health Study were followed-up from 2009 through 2013. Multivariable health expenditure ratios (HERs) of diabetes mellitus (DM), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), and hypertension with and without AO were calculated with reference to no risk factors using a Tweedie regression model.ResultsWithout AO, HERs were 1.58 for DM, 1.06 for high LDL-C, 1.27 for low HDL-C, and 1.31 for hypertension (all P < 0.05). With AO, HERs were 1.15 for AO, 1.42 for DM, 1.03 for high LDL-C, 1.11 for low HDL-C, and 1.26 for hypertension (all P < 0.05, except high LDL-C). Without AO, population attributable fractions (PAFs) were 2.8% for DM, 0.8% for high LDL-C, 0.7% for low HDL-C, and 6.5% for hypertension. With AO, PAFs were 1.0% for AO, 2.3% for DM, 0.4% for low HDL-C, and 5.0% for hypertension.ConclusionsOf the obesity-related cardiovascular risk factors, hypertension, independent of AO, appears to impose the greatest burden on Japanese health expenditures.
Highlights
Ratios of total health expenditures to Gross Domestic Product have been increasing in most Organization for Economic Cooperation and Development (OECD) countries.[1]
Sairenchi et al / Journal of Epidemiology 27 (2017) 354e359 lipoprotein cholesterol (HDL-C) levels, and hypertension, which are major risk factors for cardiovascular risk factors in terms of obesity and metabolic syndrome, with health expenditures.4e14 Several studies have shown that metabolic syndrome per se and abdominal obesity might not have an important effect on health expenditures in the United States of America (USA) and Taiwan.[4,5]
To the best of our knowledge, the present study is the first to show that the obesity-related cardiovascular risk factor related to the greatest attribution on the Japanese National Health Insurance expenditures was hypertension, independent of abdominal obesity
Summary
Ratios of total health expenditures to Gross Domestic Product have been increasing in most Organization for Economic Cooperation and Development (OECD) countries.[1]. The aim of this study was to examine the attribution of each cardiovascular risk factor in combination with abdominal obesity (AO) on Japanese health expenditures. Multivariable health expenditure ratios (HERs) of diabetes mellitus (DM), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), and hypertension with and without AO were calculated with reference to no risk factors using a Tweedie regression model. Without AO, population attributable fractions (PAFs) were 2.8% for DM, 0.8% for high LDL-C, 0.7% for low HDL-C, and 6.5% for hypertension. Conclusions: Of the obesity-related cardiovascular risk factors, hypertension, independent of AO, appears to impose the greatest burden on Japanese health expenditures
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