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Inadequate Treatment For Hypertension And High Cholesterol A Problem In The USA

July 13, 2017

Two-thirds of all US adults with hypertension (high blood pressure) and high cholesterol are not getting effective treatment, says a new report called "Vital Signs" issued by the CDC (Centers for Disease Control and Prevention), and 80% of them have the necessary health insurance cover to do something about it.

Treatment for hypertension and high cholesterol is relatively cheap and extremely effective, the authors explained. If these two risk factors are not controlled, the patient runs a significantly higher risk of having a stroke, heart attack, and other serious diseases.

The authors wrote that the lowest rates of control are among those with either none or inadequate health insurance cover.

An 80% figure for those with high blood pressure and high cholesterol with good insurance cover is of concern, because it shows that insurance alone is not enough to control these potentially fatal conditions.

Strokes, heart attacks and other vascular diseases kill over 800,000 US people annually. Hypertension and high cholesterol are major risk factors for these diseases. 150,000 of these premature deaths occur among individuals less than 65 years of age.

Thomas R. Frieden, M.D., M.P.H., CDC director, said:

"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. We need to do a better job improving care and supporting patients to prevent avoidable illness, disability, and death."

The American $300 billion annual cardiovascular disease bill in direct medical costs is going up fast, the CDC informs. One-sixth of all health care dollars spent go towards these types of diseases.

The Vital Signs report revealed that: 1 in every 3 adults has hypertension A third of those with hypertension remain untreated Half of those with hypertension do not have their condition under control One third of all adults have high cholesterol Half of all adults with high cholesterol remain untreated Two-thirds of all adults with high cholesterol do not have their condition under control Individuals with the lowest rates of control: Had no health insurance cover whatsoever Had no usual source of medical care Had received medical care less than twice over the last twelve months Were below the US considered poverty level The authors also revealed that Mexican Americans had poor rates of control over the blood pressure and cholesterol levels.

The American system needs a comprehensive approach, including system and policy changes to improve access to health care, quality of preventive care, and patient compliance.

Blood pressure and cholesterol screening coverage with no cost sharing is provided for in the Affordable Care Act, the report states.

The authors say that electronic health records with registry and reminder functions would significantly improve follow-up treatment and management. Patient compliance (adherence) to medications and instructions can be positively influenced with a stronger participation by allied health professionals, such as nurses, pharmacists, health educators and dieticians.

The CDC and other federal agencies are liaising to address the cardiovascular disease problem. Their aims are to improve coordination of care, focus more on population health, and to support the Healthy People 2020 cardiovascular health goals and objectives.

Several public health efforts, including the Let's Move initiative aim to help US citizens adopt healthier lifestyles, such as becoming more physically active, eating healthy and well-balanced meals, and maintaining a healthy body weight.

Bad cholesterol, also known as LDL cholesterol should be under 160 for individuals without diabetes or heart disease, less than 130 for those with at least two risk factors for heart disease but no heart attack or diabetes, and below 100 for those with diabetes or heart disease. Ideal blood pressure should be less than 120/80 - if it is more than 140/90 it requires management.

In a communiqué, the CDC wrote:

"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."

"Vital Signs"
Centers for Disease Control and Prevention