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Most Americans with High Blood Pressure and High Cholesterol at Unnecessary Risk for Heart Attack and Stroke
80 percent of adults with uncontrolled blood pressure or high cholesterol have insurance and availability to low cost effective treatment
Two out of three U.S. adults with high cholesterol and half of U.S. adults with high blood pressure are not being treated effectively, according to the latest Vital Signs report from the Centers for Disease Control and Prevention.
Although treatment of high blood pressure and high cholesterol is very effective and relatively low-cost, most people with these conditions remain at elevated risk for heart attacks, strokes, and other problems. People who lack health insurance have the lowest rates of control. Among those whose blood pressure or cholesterol is not under control, more than 80 percent have private or public health insurance – showing that health care coverage is necessary but, for most people, not enough to control these leading killers.
High blood pressure and cholesterol are two major risk factors for heart attacks, strokes, and related vascular diseases, which kill more than 800,000 Americans each year – more than any other condition. Of these, 150,000 are younger than age 65.
"Although we're making some progress, the United States is failing to prevent the leading cause of death—cardiovascular disease—despite the existence of low cost, highly effective treatments," said Thomas R. Frieden, M.D., M.P.H., CDC director. "We need to do a better job improving care and supporting patients to prevent avoidable illness, disability, and death."
Cardiovascular disease costs the nation an estimated $300 billion each year in direct medical costs and those costs are increasing rapidly. Treatment for this disease accounts for $1 in every $6 US health dollars spent. The report examined data from the National Health and Nutrition Examination Survey (NHANES), an ongoing study that explores the health and nutritional status of about 5,000 participants every year.
Among the findings in the Vital Signs Report:
- By the Numbers – High Blood Pressure
- 1 in 3 Adults has high blood pressure
- 1 in 3 Adults with high blood pressure does not get treatment
- 1 in 2 Adults with high blood pressure does not have it under control
- By the Numbers – High Cholesterol
- 1 in 3 Adults has high cholesterol
- 1 in 2 Adults with high cholesterol does not get treatment
- 2 in 3 Adults with high cholesterol do not have it under control
The Vital Signs report also noted that control rates for high blood pressure and high cholesterol are especially low among people in certain socioeconomic and ethnic groups. Those with the lowest rates of control had no health insurance, no usual source of medical care, had received care less than twice in the last year, or had income below the poverty level. Rates of control also were low among young adults and Mexican Americans.
To improve blood pressure and cholesterol control levels among U.S. adults in every age group, a comprehensive approach that involves policy and systems changes to improve health care access, quality of preventive care, and patient adherence to treatment is needed, according to the authors of the report.
The Affordable Care Act provides coverage for blood pressure and cholesterol screenings with no cost sharing. Additional health care system improvements including electronic health records with registry and reminder functions can improve follow up treatment and management. Allied health professionals (nurses, dietitians, health educators, and pharmacists) can also help increase patient adherence to medications.
In CDC is collaborating with other federal agencies to address cardiovascular disease by improving coordination of care, increasing attention to population health, supporting Healthy People 2020 cardiovascular health goals and objectives. In addition, the agency is complementing the Let's Move initiative and other public health efforts that help Americans make healthy lifestyle choices, such as staying active, eating well and maintaining a healthy weight.
It's important for individuals to understand healthy markers when it comes to cholesterol and blood pressure. LDL cholesterol (or bad cholesterol) should be less than 160 for people without heart disease or diabetes; less than 130 for people without heart disease or diabetes but with two or more other risk factors for heart disease; and below 100 for people with heart disease or diabetes. Blood pressure should be less than 120 over 80 and requires management if it is higher than 140 over 90.
Also, patient adoption of healthy behaviors is critical. Individuals can take steps to lower cholesterol and blood pressure and improve their heart health by consuming a diet that is low in sodium; low in total fat, saturated fat and cholesterol; rich in fruits and vegetables; and balanced with a healthy level of exercise. Making a healthy diet accessible and affordable for all Americans is an important part of the solution. Food producers and processors, restaurants, and fast food businesses can help by reducing salt in our foods, according to the report.
For more information on heart disease, visit www.cdc.gov/vitalsigns or www.cdc.gov/dhdsp. To learn more about how heart disease affects your community, visit www.cdc.gov/dhdsp/ncvdss.
About Vital Signs
CDC Vital Signs is a report that appears on the first Tuesday of the month as part of the CDC journal Morbidity and Mortality Weekly Report (MMWR). Vital Signs is designed to provide the latest data and information on key health indicators – cancer prevention, obesity, tobacco use, alcohol use, access to health care, HIV/AIDS, motor vehicle passenger safety, health care-associated infections, cardiovascular health, teen pregnancy, infant mortality, asthma and food safety.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
- Historical Document: February 1, 2011
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