Follow the Heart: Supporting Employees in Achieving Better Cardiovascular Health

Cardiovascular disease is the leading cause of death globally. Employers play a pivotal role in supporting employees managing their cardiovascular health through workplace initiatives.


February 26, 2024

Although cardiovascular disease (CVD) is often preventable, it has been the leading cause of death globally for decades, claiming an estimated 17.9 million lives every year.1 Business Group on Health’s 2024 Large Employer Health Care Strategy Survey found that over the past 2 years, 30% of surveyed employers ranked cardiovascular disease as one of their top three conditions driving health care costs.2 Beyond direct costs, CVD significantly impacts employee productivity and well-being, with indirect costs estimated at $168.0 billion between 2019 and 2020.3

The good news is that many underlying drivers of CVD can be controlled, prevented and/or managed through evidence-based lifestyle changes. Among the most impactful is smoking cessation; research indicates that quitting smoking can halve the risk of heart disease within a year, contributing significantly to the reduction of CVD mortality rates.4

The American Heart Association has played a pivotal role in the monumental strides made in cardiovascular health. Through dedicated scientific research focused on the causes, prevention, diagnosis and treatment of cardiovascular diseases, significant achievements have emerged. This research has led to a dramatic 70% decrease in heart disease rates from 1950 to 2021, highlighting the critical importance of ongoing efforts in health awareness and prevention strategies, as well as the innovation of new treatments to effectively combat cardiovascular disease.5

Employers can take action by promoting tailored health awareness campaigns, investing in prevention, early detection and effective management of CVD risk factors. Programs that promote physical activity and healthy lifestyles can also be beneficial in mitigating some of the negative effects related to physical inactivity and/or living with obesity, both of which are significant contributors to CVD. In addition, through implementing preventive and tailored patient support programs, employers have an opportunity to address a spectrum of employee needs while advancing health equity among populations disproportionately affected by CVD.

What Is Cardiovascular Disease?

CVD encompasses a group of disorders of the heart and blood vessels, including coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. CVD has many causes, including smoking, living with obesity, diabetes, high blood pressure and even exposure to air pollution, to name a few.6 In addition to these environmental factors, genetics also play a significant role in CVD risk. Certain genes can increase susceptibility to CVD by influencing cholesterol levels, blood pressure, and other factors.7

Gender Disparity in CVD: A Focus on Women’s Health

Despite being the leading cause of death in women worldwide 8, only about 56% of women recognize that heart disease is their primary health threat, and many underestimate their risk compared to other diseases like breast cancer.9 Among the risk factors for women, high blood pressure stands out, affecting nearly 56 million women in the U.S.10, yet less than a quarter of these cases are being well managed. Additionally, there are unique female factors contributing to heart disease risk. These include early menopause, polycystic ovary syndrome, gestational diabetes and hypertensive disorders during pregnancy.10 Each of these conditions underscores the critical need for increased awareness and better management of heart disease risk in women.

Women often experience different heart disease symptoms than men. These can include unusual fatigue, sleep disturbances, shortness of breath, indigestion, anxiety or heart racing, sometimes occurring as early as a month before a heart attack.11 During a heart attack, women might not experience the classic chest pain but instead feel pressure or tightness, alongside symptoms like nausea and abdominal, neck and shoulder pain.11 These differences in symptoms place women at a greater risk of not receiving the necessary urgent care in an emergency.

Therefore, it’s not surprising that heart disease in women often remains underrecognized. This oversight can be attributed to a historical focus on male-centric research, differences in symptoms and risk factors between genders and a lack of awareness among both women and health care providers.11

Research has revealed that heart disease may begin in childhood and develop silently, making early prevention crucial. Gender differences in coronary risk and treatment are now being recognized, with studies highlighting factors like metabolic syndrome, diabetes and smoking as particularly significant for women.11 By understanding and addressing these unique aspects of heart disease in women, it becomes possible to make significant strides in improving women's cardiovascular health.

Prevention and Treatment Options

Reducing the burden of CVD requires a multi-faceted approach that considers both modifiable and non-modifiable risk factors. This includes promoting lifestyle changes, medication adherence efforts, facilitating access to affordable and quality medical and surgical interventions and addressing genetic predispositions through early detection and targeted screening.

  • Healthy living: Adopting a heart-healthy lifestyle is a cornerstone of CVD prevention and treatment. This includes eating a balanced diet low in fats and salt, engaging in regular physical activity, getting adequate sleep and avoiding smoking.12
  • Managing symptoms and complications: When lifestyle changes alone are insufficient, medications are often necessary to control CVD symptoms and prevent complications. The specific type of medication depends on the nature of the heart disease.12
  • Devices and surgical procedures: Various devices and surgical procedures play a crucial role in treating heart disease. These include the implantable cardioverter defibrillator (ICD), used to detect and correct severe arrhythmias13; the left ventricular assist device (LVAD), a mechanical pump that aids the heart in pumping blood and is often a bridge to heart transplantation13; and percutaneous coronary intervention (PCI), a technique commonly known as angioplasty, used to reopen blocked coronary arteries.13 Each of these interventions is vital in managing different cardiac conditions and improving patient outcomes.

Recent clinical and technological advancements are dramatically enhancing the way cardiovascular, diabetes and obesity conditions are managed. Personalized medicine is at the forefront, with genetic profiling informing tailored treatments, while new medications like proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and glucagon-like peptide 1 (GLP-1) agonists are setting benchmarks in managing cholesterol and blood glucose levels, respectively.14 According to clinical trial results published in November 2023, the use of semaglutide (Wegovy®), a GLP-1 medication, decreased major adverse cardiovascular events, including non-fatal heart attack and stroke, by 20% among patients with overweight or obesity and cardiovascular disease without diabetes.15 While GLP-1s may be effective for patients with weight related comorbidities, an effective cardiovascular strategy should be centered on lifestyle intervention and supported by pharmacotherapy when appropriate.

Additional information on the effectiveness of GLP-1s, as well as other Food and Drug Administration (FDA)-approved anti-obesity medications, can be found in An Employer’s Practical Playbook for Treating Obesity.16

The American Heart Association defines cardiovascular-kidney-metabolic (CKM) syndrome as a health disorder that’s due to connections among heart disease, kidney disease, diabetes and obesity, leading to poor health outcomes. In the U.S., one in three adults have three or more risk factors that can lead to CKM syndrome. Risk factors include increased blood pressure, high blood sugar, excess body fat, high cholesterol or triglyceride levels and kidney disease — all of which increase the risk of cardiovascular disease, stroke and diabetes.17

Click here18 to learn more on how you can optimize kidney care in your benefits.

Technology-Assisted Support

One strategy that can improve access to care for patients at high risk – including those in rural or health professional shortage areas – is access to digital technology. Recent studies have highlighted the efficacy of mobile technology interventions in promoting self-management and providing automated lifestyle coaching, which are associated with improvements in systolic and diastolic blood pressure. In fact, a recent study found that engagement with a hypertension self-management platform that leverages a blood pressure monitor and smartphone app, has been shown to result in decreased blood pressure over a span of up to 22 weeks, with sustained benefits for those who remain active in the program for as long as 3 years.19 The platform operates by integrating a user's blood pressure measurements, collected through the connected monitor, with personalized insights and guidance delivered through the smartphone app. The effectiveness of such cardiovascular health solutions can be measured by looking at the correlation between the degree of engagement and the corresponding health outcomes. For instance, the research demonstrated that a higher number of blood pressure measurements entered into a mobile app was associated with better blood pressure control and a lower probability of very high blood pressure episodes.19

Local Care vs COE Programs

For patients with CVD, selecting the most appropriate care is crucial and depends on factors such as the severity and complexity of the disease, as well as accessibility to care.

For patients with less complex cardiovascular conditions, local specialists and primary care providers likely offer a care setting that is more convenient, continuous and more intuitive for patients to use. Some employers or providers may encourage patients to supplement care in the community with a use of continuous monitoring device or a virtual care program that may remove any access barriers.

For some patients, local care may be delivered through their company’s on-site clinic, offering services ranging from preventive care to chronic condition management. Advanced primary care practices, including those in direct contracts with employers, could also be a first point of contact and the most likely source of support for patients with common cardiovascular issues.20 Each of the local settings mentioned above can provide blood pressure screenings, chronic condition management, medication monitoring and lifestyle guidance, which are key in the early identification and prevention of cardiovascular diseases. By focusing on preventive measures and the handling of less severe conditions, local care promotes a sustainable health care model that improves patient outcomes through personalized and ongoing care.

For more complex and high-cost procedures, Centers of Excellence (COEs) are specialized groups of health care providers known for delivering a higher standard of care.21 They focus on achieving high-quality outcomes and meeting the specific needs of patients requiring more complex interventions, often in a cost-effective way. The predictability of cost is often achieved through bundled payment arrangements, an option utilized by 50% of employers in 2024, with an expected increase to 65% in 2025/2026.2 For employers, integrating cardiovascular COEs into their health care strategies can facilitate directing patients to high-quality care centers with highly trained specialists and advanced technology often not available locally. Patients are often incentivized to choose COEs through reduced or waived out-of-pocket costs and travel benefits, and employers benefit from the predictability of health care expenses.22

Key Considerations for Employers

By implementing comprehensive, inclusive and innovative health strategies, employers can contribute significantly to the prevention and management of CVD, ultimately leading to a healthier, more productive workforce and a reduction in health care costs.

Employers can consider the following strategies to improve the quality of care delivered to employees with cardiac conditions.

Implementing Workplace Health Initiatives

  • Health assessments and screenings: Regular health screenings and checkups can help with early detection and management of cardiovascular risk factors like hypertension, high cholesterol and obesity.
  • Promoting programs: Initiatives such as fitness activities, dietary guidance and stress management workshops not only boost employee health but also reduce health care costs.
  • Smoking cessation programs: Given the significant impact of smoking on heart health, offering support for smoking cessation is critical.23 Read more on the website, "A Roadmap to a Global Tobacco-Free Company,” by clicking here.24
  • On-Site blood pressure screenings: Facilitate convenient access to blood pressure screenings at the workplace to promote early detection of cardiovascular risk factors.

Embracing Digital Health Solutions

  • Blood pressure management: Consider coverage for home blood pressure monitors and trackers.
  • Telemedicine services: Facilitate access to virtual consultations, especially for employees with mobility issues or those living in remote areas.
  • Second opinion services: Provide a virtual second opinion program for employees pursuing cardiac surgery. Support its use through plan design incentives, if possible.

Fostering an Inclusive Approach

  • Gender-Specific health needs: Acknowledge the unique cardiovascular health challenges women face, design health awareness campaigns that educate employees about the impact of CVD in women and symptom differences; then, provide targeted support. Also, be sensitive to the needs of women around the world. Read more on how to prioritize women’s health in global benefits design here.25
  • Culturally sensitive health education: Tailor health communication to be inclusive and sensitive to the diverse backgrounds of the workforce.

Encouraging Behavioral Change

  • Education and awareness: Regularly educate employees about the risks of heart disease and the importance of a healthy lifestyle. These campaigns can include seminars, newsletters and health fairs that provide information on heart disease prevention, symptoms and healthy lifestyle choices.
  • Knowledge empowerment: Educate employees on CVD risks and prevention. Offer resources like blood pressure monitors and nutrition guides to encourage informed health decisions.

Evaluating Health Care Coverage

  • Diabetes prevention initiative: In recognition of the relationship between cardiac conditions and diabetes, offer a diabetes prevention program that can help reduce the risk of diabetes and/or help employees manage their diabetes.
  • COE program support: Offer a COE program for complex cardiac procedures. Cover travel and caregiver accommodations, if possible.

Promoting a Healthy Work Environment

  • Physical environment: Create a workplace that encourages physical activity, such as standing desks, walking meetings and accessible stairwells. These measures can also help address obesity. The Employer’s Practical Playbook for Treating Obesity has numerous suggestions and can be accessed here.17
  • Mental health support: Address workplace stressors and promote a healthy work-life balance. Provide support for mental health, including access to counseling services, employee assistance programs and initiatives that address workplace stress.
  • Heart-Healthy work culture: Cultivate an environment that prioritizes health and supports healthy choices. For instance, providing healthy food options, encouraging breaks for physical activity and creating a smoke-free workplace are all good initiatives.

Other Considerations

  • Health metrics: Measure the impact of health initiatives on employee health outcomes and productivity. This could include tracking participation rates and employee health outcomes, as well as obtaining feedback from employees.
  • Offer training to save lives at work: Provide CPR certification training and ensure an AED (automated external defibrillator) is accessible on-site, equipping staff with the knowledge and tools to respond effectively in emergency situations.

Related Resources

More Topics

Articles & Guides icon_right_chevron_dark Health Conditions and Risk Factors icon_right_chevron_dark Health Equity icon_right_chevron_dark Physical Health icon_right_chevron_dark
More in Benefits Strategy


  1. Gender Disparity in CVD: A Focus on Women’s Health
  2. Prevention and Treatment Options
  3. Technology-Assisted Support
  4. Local Care vs COE Programs
  5. Key Considerations for Employers