A New Era in Cardiovascular Risk Management: The Power of Precision Biology and Medication

Cardiovascular disease (CVD) is a significant economic burden for employers and health plans. Here are some key facts:

1. Direct Medical Costs: According to the American Heart Association, the direct medical costs of CVD, including hospitalizations, medications, and associated health care services, are projected to increase to $749 billion by 2035 in the United States.
2. Indirect Costs: Indirect costs associated with CVD, such as lost productivity due to illness or premature death, are also substantial. These costs are projected to increase to $368 billion by 2035.
3. Costs for Employers: The costs of CVD can be significant. A study published in the Journal of Occupational and Environmental Medicine found that employees with CVD had more than double the healthcare costs of employees without these conditions. Additionally, employees with CVD had significantly higher rates of absenteeism and presenteeism (reduced productivity while at work), further adding to the costs for employers.
4. Costs for Health Plans: The costs of CVD are also substantial for health plans. According to a study published in the American Journal of Managed Care, the average annual healthcare costs for a person with heart disease are more than triple those for a person without heart disease.

In the past, managing obesity and cardiovascular risk was often a game of willpower and lifestyle changes. However, this approach has proven ineffective and risky, with only a tiny percentage of people achieving long-term success. We're entering a new era of cardiovascular risk management that leverages the power of precision biology and medication.

Given these costs, there's a solid economic case for investing in effective, personalized treatments for obesity and CVD. By helping individuals manage their weight and improve their cardiovascular health, these treatments can save employers, and health plans billions of dollars in healthcare costs and lost productivity.

The future of cardiovascular risk management is here. It's an approach that recognizes the complexity of obesity and cardiovascular risk and leverages the power of genetics, gut microbiome, insulin metabolism, and medication to deliver personalized, effective treatment plans. Recent research suggests that treating obesity can positively impact cardiovascular outcomes.

Today, we will delve into three promising areas in treating and preventing cardiovascular risks associated with obesity: GLP-1 receptor agonists, genetic data, and gut microbiome data.

One of the most exciting developments in this field is using GLP-1 receptor agonists, such as Wegovy and Ozempic. These drugs, traditionally used for managing diabetes, are now used to address obesity and reduce cardiovascular risk. A recent study published in the Journal of the American College of Cardiology showed that GLP-1 receptor agonists significantly reduced body weight and improved metabolic parameters to reduce cardiovascular risk.

Several ongoing trials, including the SELECT trial (using semaglutide), the SURPASS CVO trial, the SUMMIT trial, and the SURMOUNT-MMO trial (all three using tirzepatide, another GLP-1 receptor agonist), are exploring the impact of these drugs on cardiovascular outcomes in people with obesity.

But the use of medication is just one part of the equation. Precision biology, which involves understanding an individual's unique genetic makeup and gut microbiome, is also crucial in managing cardiovascular risk.

Digbi Health, a precision biology company, is leading this field. Digbi's team of doctors, engineers, and genetic and microbiome scientists developed a scientifically-backed, clinically managed weight loss program that tailors treatment plans to the individual based on their unique genetic makeup, gut microbiome, and clinical needs. This personalized approach offers tremendous savings for employers and payers and ensures that individuals are not unnecessarily bound to life-long GLP-1 treatment.

The role of genetics in obesity and cardiovascular risk cannot be overstated. A study published in Nature Genetics journal identified 97 genetic variants associated with obesity, many in brain regions that influence eating behaviors. This suggests that our genes can significantly impact our body weight and, consequently, our cardiovascular risk.

South Asian populations, including those of Indian descent, are at a higher risk of cardiovascular disease (CVD) than other ethnic groups. This heightened risk can only be partially explained by conventional risk factors, suggesting the need for a specific cardiovascular risk profile for South Asians. Genetic risk factors, such as lipoprotein(a), are believed to play a role, in addition to population-specific gene modulating factors.

The gut microbiome, the community of microorganisms living in our intestines, also plays a crucial role in obesity and cardiovascular risk. Research has shown that the gut microbiota contributes to the development and progression of the illness. Gut microbiota-derived chemicals, such as short-chain fatty acids and secondary bile acids, uniquely affect the progression of CVD.

A specific gut microbiota-derived metabolite, indole-3-propionic acid (IPA), was found to be substantially decreased in patients with CVD and negatively associated with CVD risk.

Healthcare providers can gain insights into these imbalances by analyzing the gut microbiome and developing personalized treatment strategies, such as probiotics or dietary changes, to help restore a healthy gut microbiome and support weight management.

So, what does this mean for you? If you're struggling with obesity and high cardiovascular risk, there's hope. The combination of precision biology and medication offers a new, more effective approach to managing your health. By understanding your unique genetic makeup and gut microbiome, and potentially using GLP-1 receptor agonists, you can significantly reduce your body weight and improve your cardiovascular health.

Digbi Health applies a precision biology approach and AI to direct obese and overweight members to the best care path. Some individuals may reach their weight goals through food-as-medicine, others may benefit from a combination of food-as-medicine and lower-cost drugs like Metformin, while some might require a comprehensive lifestyle care plan that includes GLP-1s. This personalized approach offers tremendous savings for employers and payers.