Simulating and Evaluating Local Interventions to Improve Cardiovascular Health

Figure 2. Estimated impacts of a 15-component intervention, with ranges based on sensitivity testing, simulation model for cardiovascular disease (CVD) outcomes. The 15 interventions are listed in Table 1 under the topical clusters of Care, Air, and Lifestyle.

Key:
Blue line = base case results.
Black line = expected reduction in death rate or costs from the 15-component intervention when the impact parameters are all set to their baseline values.
Orange shaded area around the black line = envelope of plausible outcomes in the 15-component intervention outcomes based on sensitivity testing. Upper edge (least impact) results when all uncertain impact parameters are set to their lowest values, while lower edge (most impact) results when all uncertain impact parameters are set to their greatest values.
Gray line = the model’s calculation of what the death rate or costs would be if all of the risk factors in the model — smoking, small particulate matter (PM 2.5) air pollution, high blood pressure, high cholesterol, diabetes, obesity, poor nutrition, inactivity, and stress — were reduced to zero.

This figure consists of 2 line graphs that portray simulated death rate and cost outcomes for a 15-component intervention, showing the mean trajectory and upper and lower ranges based on sensitivity.

The graph on the left has an X axis labeled with the years 1990 to 2040 and a Y axis labeled “Deaths from CVD per 1,000.” The Y axis ranges from zero to 4. A blue line indicates the base case, with a death rate that starts at 3.70 deaths per 1,000 in 1990, dips to a low point of 2.37 in 2003, and rises gradually to 3.23 in 2040. A black line indicates the lower death rate that results from a 15-component intervention, implemented in 2009, with uncertain parameters all set to their baseline values. It quickly drops to 2.04 deaths per 1,000 in 2010 (compared with 2.50 in the base case), then gradually rises to 2.62 in 2040. The black line is surrounded by an orange shaded area that indicates a range of plausible death rate outcomes for the 15-component intervention. The upper edge (least impact — all uncertain impact parameters set to their lowest values) begins at 2.14 deaths per 1,000 in 2010 and rises gradually to a rate of 2.77 in 2040. The lower edge (most impact — all uncertain impact parameters set to their highest values) begins at 1.87 in 2010 and rises gradually to 2.41 in 2040. A gray line indicates a CVD death rate if all risk factors are set to zero. It begins at a rate of 1.32 deaths per 1,000 in 1990, declines to a low point of 0.96 in 2003, and rises gradually to 1.35 in 2040.

Volume 7: No. 1, January 2010