Cardiovascular Disease Policy Model

The Cardiovascular Disease (CVD) Policy Model is a population-level state-transition computer simulation of cardiovascular disease. It has been used for more than 30 years to represent trends in CVD risk factors, outcomes and healthcare costs in the United States adult population.

Research using the CVD Policy Model focuses on understanding trends in CVD risk factors and treatments and evaluating the population-level impact of interventions aimed at reducing the burden of cardiovascular disease.

The model has been used to evaluate the impact and cost effectiveness of CVD prevention and treatment strategies ranging from public health interventions to clinically targeted approaches. Examples of past projects include assessing the impact of dietary salt reductions, soda taxation, emerging therapies to reduce low-density lipoprotein cholesterol, and implementation of national guidelines for treating elevated blood pressure.

Though originally designed to be nationally representative of the US population, the model has been adapted in recent years to examine subpopulations such as Veteran's Affairs population and non-Hispanic blacks, as well as populations of other countries including Mexico, China, Argentina and Canada. This work has resulted in several high impact publications in the New England Journal of Medicine, JAMA, Annals of Internal Medicine, Circulation and Health Affairs.

The CVD Policy Model research group is a bicoastal, multi-disciplinary team of investigators and staff using computer simulation methods to address clinical and policy-oriented research questions related to cardiovascular disease. Dr. Kirsten Bibbins-Domingo leads the west coast CVD Policy Model team, which is located in the Department of Epidemiology and Biostatistics at the University of California, San Francisco. She and her team collaborate closely with Drs. Lee Goldman and Andrew Moran at Columbia University in New York as well as diverse investigators, staff and trainees undertaking computer simulation modeling projects at UCSF, Columbia University and other institutions in the United States and around the world.

Samples of our published work can be found below. Researchers interested in learning more about our work should contact Dr. Kirsten Bibbins-Domingo (CVD Policy Model principal investigator) or Joanne Penko (CVD Policy Model project manager at UCSF).

Selected Publications Based on the CVD Policy Model

Health Policy

  • Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood LM, Pletcher MJ, Goldman L. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med. 2010;362(7):590-599.
  • Bibbins-Domingo K, Coxson P, Pletcher MJ, Lightwood J, Goldman L. Adolescent overweight and future adult coronary heart disease. N Engl J Med. 2007;357(23):2371-2379.
  • Dhruv S. Kazi, Pengxiao C. Wei, Joanne Penko, Brandon K. Bellows, Pamela Coxson, Kelsey B. Bryant, Valy Fontil, Ciantel A Blyler, Courtney Lyles, Kathleen Lynch, Joseph Ebinger, Yiyi Zhang, Gabriel S. Tajeu, Ross Boylan, Mark J Pletcher, Florian Rader, Andrew E. Moran, Kirsten Bibbins-Domingo. Scaling Up Pharmacist‑led Blood Pressure Control Programs in Black Barbershops: Projected Population Health Impact and Value. Circulation. 2021; 143: 2406 - 2408.

    Supplemental material available here.
  • Coxson PG, Cook NR, Joffres M, Hong Y, Orenstein D, Schmidt S, Bibbins-Domingo K. Mortality benefits from US population-wide reduction in sodium consumption: projections from 3 modeling approaches. Hypertension. 2013;61(3):564-70.
  • Mekonnen TA, Odden MC, Coxson PG, Guzman D, Lightwood J, Wang YC, Bibbins-Domingo K. Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD) policy model. PLoS One. 2013;8(12):e81723.
  • Wang YC, Coxson P, Shen YM, Goldman L, Bibbins-Domingo K. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes. Health Aff 2012;31(1):199-207.
  • Odden MC, Coxson PG, Moran A, Lightwood JM, Goldman L, Bibbins-Domingo K. The impact of the aging population on coronary heart disease in the United States. Am J Med 2011;124(9):827-33.

Clinical Guidelines

  • Heller DJ, Coxson PG, Penko J, Pletcher MJ, Goldman L, Odden MC, Kazi DS, Bibbins-Domingo K. Evaluating the impact and cost-effectiveness of statin use guidelines for primary prevention of coronary heart disease and stroke. Circulation. 2017;136(12):1087-1098.
  • Moran AE, Odden MC, Thanataveerat A, et al. Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med. 2015;372(5):447-455.
  • Pletcher MJ, Lazar L, Bibbins-Domingo K, Moran A, Rodondi N, Coxson P, Lightwood J, Williams L, Goldman L. Comparing impact and cost-effectiveness of primary prevention strategies for lipid-lowering. Ann Intern Med. 2009;150(4):243-54. 

Clinical Medicine

  • Kazi DS, Moran AE, Coxson PG, et al. Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease. JAMA. 2016;316(7):743-753. doi: 710.1001/jama.2016.11004.
  • Kazi DS, Penko J, Coxson PG, Guzman D, Wei PC, Bibbins-Domingo. Cost-Effectiveness of Alirocumab: A Just-in-Time Analysis Based on the ODYSSEY Outcomes Trial. Annals of Internal Medicine. 2019;170(4):221-229. doi: 10.7326/M18-1776.

    Video content available here.

  • Kazi DS, Penko J, Coxson PG, Moran AE, Ollendorf DA, Tice JA, et al. Updated Cost-effectiveness Analysis of PCSK9 Inhibitors Based on the Results of the FOURIER Trial. JAMA. 2017;318:748-50. doi: 10.1001/jama.2017.9924.
  • Kazi DS, Penko J, Ollendorf DA, Coxson PG, Bibbins-Domingo K. Effect of Money-Back Guarantees on the Cost-Effectiveness of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors. Annals of Internal Medicine. 2018;168(12):896-898. doi: 10.7326/M17-3367

   Online Supplement available here.

  • Lazar LD, Pletcher MJ, Coxson PG, Bibbins-Domingo K, Goldman LCost-effectiveness of statin therapy for primary prevention in a low-cost statin era. Circulation. 2011;124:146-53.
  • Odden MC, Moran AE, Coxson PG, Peralta CA, Goldman L, Bibbins-Domingo K. Gait speed as a guide for blood pressure targets in older adults: a modeling study. J Am Geriatr Soc 2016;64(5):1015-23.
  • Odden MC, Pletcher MJ, Coxson PG, Thekkethala D, Guzman D, Heller D, Goldman L, Bibbins-Domingo K. Cost-effectiveness and population impact of statins for primary prevention in adults aged 75 years or older in the United States. Ann Intern Med 2015;162(8):533-541. 

Global Health

  • Konfino J, Mekonnen TA, Coxson PG, Ferrante D, Bibbins-Domingo K. Projected impact of sodium consumption reduction initiative in Argentina: an analysis from the CVD Policy Model-Argentina. PLoS One. 2013;8(9):e73824.
  • Sanchez-Romero LM, Penko J, Coxson PG, Fernandez A, Mason A, Moran AE, Avila-Burgos L, Odden M, Barquera S, Bibbins-Domingo K. Projected impact of Mexico's sugar-sweetened beverage tax policy on diabetes and cardiovascular disease: a modeling study. PLoS Med. 2016;13(11)e1002158.