Case Management to Reduce Risk of Cardiovascular Disease in a County Health Care System

Abstract
Cardiovascular disease (CVD) affects 80.7 million Americans, with estimated national costs of $448.5 billion in 2008.1 Age, sex, high blood pressure (BP), smoking, dyslipidemia, obesity, and diabetes mellitus are widely recognized as major risk factors, frequently clustering and interacting multiplicatively in predicting the risk for coronary and other atherosclerotic vascular diseases.2 Although CVD and its major risk factors affect every racial/ethnic group and social class, they disproportionately burden ethnic minorities and low-income communities.1,3 These population subgroups also are more likely to receive inadequate cardiac care compared with white and higher-income individuals.4