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Cardiovascular Disease: The 45+ Market in the United States for Drugs and Medical Devices

Cardiovascular disease includes chronic conditions such as hypertension, congestive heart failure and atherosclerosis, as well as such acute conditions as myocardial infarction and cardiac arrest. While cardiovascular disease may be diagnosed at any age, it is most prevalent in later years, particularly among sedentary individuals who are also overweight or obese. With the aging of the "Baby Boom" generation, a generation that has defined the term "couch potato" and has grown up on and maintained a diet of fast-food, the incidence and prevalence of heart disease in the United States is expected to increase significantly over the next decade.

This volume of the Geriatric Medicine series will look at the mechanisms involved in the pathology of the various types of cardiovascular diseases and the specific molecular processes that define these diseases. It will also explore current treatment modalities for hypertension, congestive heart failure, arteriosclerosis, and myocardial infarction, including �-adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers, vasodilators, inotropic drugs and anti-arrhythmics, as well as various devices used to treat congestive heart failure.

It also looks at the new and emerging research and development efforts into the discovery of advanced therapeutic products that address these diseases, including the latest in biotechnological approaches and cell-based therapeutics, as well as new devices, including heart jackets and ventricular patches. We will investigate and discuss the latest in progress towards clinical development of biopharmaceuticals that may be introduced over the next decade for the treatment of cardiovascular disease at its most basic levels.

The report will look at the demographics of the aging United States population, the expected incidence and prevalence of cardiovascular disease of different types, and the United States markets for these therapeutics, currently estimated at over $6.1 billion, that are expected grow around these populations.

Table of Contents

Chapter One: Executive Summary

• Background
• Hypertension
• Arteriosclerosis, Atherosclerosis
• Congestive Heart Failure
• Scope and Methodology
• Size and Growth of Market
• Competitive Picture
• Market Trends and Factors

Chapter Two: Introduction

• Background
• Population Demographics
• Epidemiology and Pathology of Cardiovascular Diseases
  • Hypertension
  • Arteriosclerosis/Atherosclerosis
  • Congestive Heart Failure
    • Left Ventricular (LV) Failure
    • Right Ventricular (RV) Failure
    • Systolic Dysfunction
    • Diastolic Dysfunction
    • High Output Failure
  • Theories of Congestive Heart Failure
    • Hemodynamic Response Theory
    • Neurohormonal Response Theory
    • Renal Response Theory
  • Conditions Leading to Congestive Heart Failure
    • Myocardial Infarction
    • Hypertension
    • Cardiomyopathy
    • Atrial Fibrillation
    • Other Risk Factors

Chapter Three: Cardiovascular Therapeutics

• Hypertension and Antihypertensive Drugs
  • ACE Inhibitors
  • á/�(Alpha/Beta)-Blockers
  • Calcium Channel Blockers
  • Diuretics
  • Angiotensin II Receptor Antagonists
• Atherosclerosis/Arteriosclerosis Therapy
  • Antilipemic Agents
  • Blood Modifiers
    • Anticoagulants
    • Antiplatelet Agents
    • Antithrombin III
    • Thrombin Inhibitors
    • Thrombolytic Agents
  • Surgical Stents
  • Clinical, Business, and Regulatory Developments in Drug-Eluting Stents
  • Alternatives to Drug-Eluting Stents
• Congestive Heart Failure Treatment
  • Left Ventricular (LV) Failure
  • Right Ventricular (RV) Failure
  • Systolic Dysfunction
  • Diastolic Dysfunction
  • High Output Failure
  • Hemodynamic Response Theory
  • Neurohormonal Response Theory
  • Renal Response Theory
  
  
  • ACE Inhibitors and Related Drugs
  • Angiotensin II Receptor Blockers
  • �-Blockers
    • Mild Heart Failure
    • Moderate Heart Failure
    • Severe Heart Failure
  • Diuretics
  • Positive Inotropic Agents
  • Vasodilators
  • Supplements
  • CHF Devices
    • Bridge to Transplant
    • Extended Use
    • Intervention Device Products
• Emerging Therapeutic Approaches
  • Pharmacological Approaches
    • Atacand® (candesartan cilexetil, AstraZeneca)
    • Avapro® (irbesartan, Bristol-Myers Squibb)
    • Celacade™ (Vasogen)
    • Citicoline (Indevus)
    • CVT-510 (tecadenoson, Cardiovascular Therapeutics)
    • Enoximone (Myogen)
    • Exanta® (ximelagatran, AstraZeneca)
    • Ezetimibe/Simvastatin Tablet (Merck/Schering-Plough)
    • E2F Decoy (Corgentech)
    • HRC 102 (Hemosol Research Corporation)
    • ReoPro® (abciximab, Centocor/Eli Lilly)
    • Sitaxsentan (Encysive Pharmaceuticals)
    • Vanlev® (omapatrilat, Bristol-Myers Squibb)
    • Veletri™ (tezosentan, Actelion)
  • Device Approaches

Chapter Four: Market Analysis

• Market Size and Growth
  • Overview: The Total Market Potential
• The 45+-Year-Old Market: A General View
• Congestive Heart Failure
• Arteriosclerosis
• Cardiovascular Market Potentials by Age Sub-Segment
• Market Potential by Age Sub-Segment within Condition
  • Hypertension
  • Arteriosclerosis
  • Congestive Heart Failure
• Competitive Outlook
• Market Trends

Chapter Five: Conclusions and Strategic Implications

• First Conclusion
• Second Conclusion
• Third Conclusion
• Fourth Conclusion
• Fifth Conclusion
• Sixth Conclusion
• Seventh Conclusion
• Eighth Conclusion
• Ninth Conclusion

Chapter Six: Company Profiles

• Overview
• Abbott Laboratories
• Abiomed, Inc.
• Acorn Cardiovascular, Inc.
• Actelion, Ltd.
• Arrow International
• Astra Zeneca
• Aventis Pharma USA Division of Aventis
• Bioheart, Inc.
• Boston Scientific
• Bristol-Myers Squibb
• Cardioenergetics, Inc.
• Cordis Corporation (A Johnson & Johnson Company)
• CV Therapeutics
• Encysive Pharmaceuticals (Formerly Texas Biotechnology Corporation)
• Geron Corporation
• GlaxoSmithKline
• Guidant Corporation
• Medtronic, Inc.
• MicroMed Technology, Inc.
• Myocor, Inc.
• Myogen
• Pfizer, Inc.
• St. Jude Medical
• Somanetics Corporation
• Thoratec Corporation

Appendix: Company Directory

List of Exhibits
Chapter One: Executive Summary

• Table 1-1: Prevalence of Cardiovascular Diseases (CVD) in the United States for the Total Population and Those 45 Years of Age and Older: 2003-2013
• Figure 1-1: Trending in U.S. Cardiovascular Disease Prevalence in the General Population and the 45+ Year Old Age Group: 2003 - 2013
• Figure 1-2: Trending in U.S. Hypertension Cases in the 45+ Year Old AgeGroups: 2003-2013
• Figure 1-3: Trending in U.S. Arteriosclerosis Cases in the 45+-Year-Old AgeGroups: 2003-2013
• Figure 1-4: Trending in U.S. Congestive Heart Failure (CHF) Cases in the 45+-Year-Old Age Groups: 2003-2013
• Table 1-2: The Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market (SAMP-45+) for Hypertension, Arteriosclerosis, and Congestive Heart Failure Therapeutics in the 45+-Year-Old Population 2003-2013
• Figure 1-5: Trending in the Total Projected U.S. Total Available Market Potential and Serviceable Available Market Potential for Cardiovascular Therapeutics in the 45+-Year-Old Population 2003-2013

Chapter Two: Introduction

• Figure 2-1: Growth of the World’s Elderly (60+ Years) Population2001 - 2025
• Figure 2-2: Population Distribution of the United States by Age and Sex for1999 and 2025
• Figure 2-3: The Growing U.S. Population 2003-2013
• Figure 2-4: Increasing Median Age of the U.S. Population
• Figure 2-5: Increasing Mean Age of the U.S. Population
• Table 2-1: Aging of the U.S. Population in the Age Groups 45 Years and Older 2003-2013
• Figure 2-6: Aging Trends in the U.S. Population for the Age Groups 45 Years and Older 2003-2013
• Figure 2-7: Changes in the Composition of the 45 Year-Old and Older Age Segment in the United States: 2003 and 2013
• Table 2-2: Older Population Groups as Percentages of the Total U.S. Population by Age Group 2003-2013
• Figure 2-8: Aging Trends by Percentage of the U.S. Population for the Age Groups 45 Years and Older: 2003-2013
• Table 2-3: Prevalence of Cardiovascular Diseases (CVD) in the United States for the Total Population and Those 45 Years of Age and Older: 2003-2013
• Figure 2-9: Trending in U.S. Cardiovascular Disease (CVD) Cases in the General Population and the 45+ Year Old Age Group 2003 - 2013
• Table 2-4: Prevalence of Hypertension Cases in the United States for Those 45Years of Age and Older by Age Groups 2003-2013
• Figure 2-10: Trending in U.S. Hypertension Cases in the 45+-Year-Old Age Groups 2003-2013
• Table 2-5: Prevalence of Arteriosclerosis Cases in the United States for Those 45Years of Age and Older by Age Groups 2003-2013
• Figure 2-11: Trending in U.S. Arteriosclerosis Cases in the 45+-Year-Old AgeGroups 2003-2013
• Table 2-6: Common Contributors to Congestive Heart Failure
• Table 2-7: Prevalence of Congestive Heart Failure (CHD) Cases in the United Statesfor Those 45 Years of Age and Older by Age Groups: 2003-2013
• Figure 2-12: Trending in U.S. Congestive Heart Failure (CHF) Cases in the 45+-Year-Old Age Groups: 2003-2013

Chapter Three: Cardiovascular Therapeutics

• Table 3-1: Common ACE Inhibitors on the Market for Hypertension
• Table 3-2: Common Adrenergic Receptor (á and �) Blockers on the Market for Hypertension
• Table 3-3: Common Calcium Channel Blockers on the Market for Hypertension
• Table 3-4: Common Diuretic Products on the Market for Hypertension
• Table 3-5: Common Combined Diuretic Products on the Market forHypertension
• Table 3-6: Common Angiotensin II Receptor Antagonists on the Market for Hypertension
• Table 3-7: Commonly Used Anti-Lipemic Agents on the Market for theTreatment of Dyslipidemia
• Table 3-8: Commonly Used Blood Modifying Agents on the Market for theTreatment of Cardiovascular Disease
• Table 3-9: Candidate Compounds for Drug-Eluting Stents
• Table 3-10: Therapeutic Strategies for Symptomatic Congestive Heart Failure
• Table 3-11: Pharmacological Response to the Pathophysiology of CardiacPerformance
• Table 3-12: Common Inotropic Drugs Available for the Treatment of CHF
• Table 3-13: Common Vasodilators Available for the Treatment of CHF
• Table 3-14: Biventricular Pacemakers for CHF Therapy
• Table 3-15: Cardioverter/Defibrillators (ICD) Available for Use in theTreatment of CHF
• Table 3-16: Ventricular Assist Devices (VADs) on the Market and inDevelopment
• Table 3-17: New Drugs in Development for Cardiovascular Conditions
• Table 3-18: Key New Devices in Development for Cardiovascular Therapy

Chapter Four: Market Analysis

• Table 4-1: The Total Projected U.S. Total Available Market Potential (TAMP) and Serviceable Available Market (SAMP) for Hypertension, Arteriosclerosisand Congestive Heart Failure Therapeutics 2003-2013
• Figure 4-1: Trending in the Total Projected U.S. Total Available Market Potential (TAMP) and Serviceable Available Market Potential (SAMP) for Hypertension, Arteriosclerosis and Congestive Heart FailureTherapeutics 2003-2013
• Figure 4-2: Trending in the Total Projected U.S. Total Available Market Potential (TAMP) and Serviceable Available Market Potential (SAMP) For the Treatment of Hypertension 2003-2013
• Figure 4-3: Trending in the Total Projected U.S. Total Available Market Potential (TAMP) and Serviceable Available Market Potential (SAMP) for the Treatment of Congestive Heart Failure 2003-2013
• Figure 4-4: Trending in the Total Projected U.S. Total Available Market Potential (TAMP) and Serviceable Available Market Potential (SAMP) for the Treatment of Arteriosclerosis 2003-2013
• Table 4-2: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for Hypertension, Arteriosclerosis and Congestive Heart Failure Therapeutics in the45+-Year-Old Population 2003-2013
• Figure 4-5: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) for Hypertension, Arteriosclerosis and Congestive Heart Failure Therapeuticsin the 45+-Year-Old Population 2003-2013
• Table 4-3: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for Congestive HeartFailure Therapeutics in the 45+-Year-Old Population 2003-2013
• Figure 4-6: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) Congestive Heart Failure Therapeutics in the 45+-Year-OldPopulation 2003-2013
• Figure 4-7: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) Congestive Heart Failure Drugs in the 45+-Year-Old Population2003-2013
• Figure 4-8: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) Congestive Heart Failure Devices in the 45+-Year-Old Population2003-2013
• Table 4-4: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for Arteriosclerosis Therapeutics in the 45+-Year-Old Population: 2003-2013
• Figure 4-9: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+)for Arteriosclerosis Therapeutics in the 45+-Year-Old Population:2003-2013
• Figure 4-10: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) Antihyperlipemic Drugs in the 45+-Year-Old Population: 2003-2013
• Figure 4-11: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+)Drug-Eluting Stents in the 45+-Year-Old Population: 2003-2013
• Figure 4-12: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+)Blood Modifying Drugs in the 45+-Year-Old Population: 2003-2013
• Figure 4-13: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45+) and Serviceable Available Market Potential (SAMP-45+) Antihypertensive Drugs in the 45+-Year-Old Population: 2003-2013
• Table 4-5: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for CardiovascularDisease Therapeutics by Age Group in the 45+-Year-Old Population2003-2013
• Figure 4-14: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45/54) and Serviceable Available Market (SAMP-45/54) for Cardiovascular Disease Therapeutics by Application in the 45-to-54-Year-Old Population 2003-2013
• Figure 4-15: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-55/64) and Serviceable Available Market (SAMP-55/64) for Cardiovascular Disease Therapeutics by Application in the 55-to-64-Year-Old Population 2003-2013
• Figure 4-16: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-65/74) and Serviceable Available Market (SAMP-65/74) for Cardiovascular Disease Therapeutics by Application in the 65-to-74-Year-Old Population: 2003-2013
• Figure 4-17: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-75+) and Serviceable Available Market (SAMP-75+) for Cardiovascular Disease Therapeutics by Application in the 75+-Year-Old Population: 2003-2013
• Table 4-6: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for AntihypertensiveDrugs by Age Group in the 45+-Year-Old Population 2003-2013
• Figure 4-18: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45/54) and Serviceable Available Market(SAMP-45/54) for Antihypertensive Drugs in the 45-to-54-Year-Old Population 2003-2013
• Figure 4-19: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-55/64) and Serviceable Available Market (SAMP-55/64) for Antihypertensive Drugs in the 55-to-64-Year-Old Population2003-2013
• Figure 4-20: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-65/74) and Serviceable Available Market (SAMP-65/74) for Antihypertensive Drugs in the 65-to-74-Year-Old Population2003-2013
• Figure 4-21: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-75+) and Serviceable Available Market (SAMP-75+) for Antihypertensive Drugs in the 75+-Year-Old Population 2003-2013
• Table 4-7: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for Arteriosclerosis Therapeutics by Age Group in the 45+-Year-Old Population2003-2013
• Figure 4-22: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45/54) and Serviceable Available Market (SAMP-45/54) for Arteriosclerosis Therapeutics in the 45-to-54-Year-Old Population2003-2013
• Figure 4-23: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-55/64) and Serviceable Available Market (SAMP-55/64) for Arteriosclerosis Therapeutics in the 55-to-64-Year-Old Population2003-2013
• Figure 4-24: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-65/74) and Serviceable Available Market (SAMP-65/74) for Arteriosclerosis Therapeutics in the 65-to-74-Year-Old Population2003-2013
• Figure 4-25: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-75+) and Serviceable Available Market (SAMP-75+) for Arteriosclerosis Therapeutics in the 75+-Year-Old Population2003-2013
• Table 4-8: The Total Projected U.S. Total Available Market Potential (TAMP-45+)and Serviceable Available Market (SAMP-45+) for Congestive HeartFailure by Age Group in the 45+-Year-Old Population: 2003-2013
• Figure 4-26: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-45/54) and Serviceable Available Market (SAMP-45/54) for Congestive Heart Failure in the 45-to-54-Year-Old Population2003-2013
• Figure 4-27: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-55/64) and Serviceable Available Market (SAMP-55/64) for Congestive Heart Failure in the 55-to-64-Year-Old Population2003-2013
• Figure 4-28: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-65/74) and Serviceable Available Market (SAMP-65/74) for Congestive Heart Failure in the 65-to-74-Year-Old Population2003-2013
• Figure 4-29: Trending in the Total Projected U.S. Total Available Market Potential (TAMP-75+) and Serviceable Available Market (SAMP-75+) forCongestive Heart Failure in the 75+-Year-Old Population2003-2013

 

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