Uncontrolled Hypertension and Cholesterol Still a Problem in the US

Although one in three American adults has hypertension, fewer than half of patients with this condition have it under control. The numbers for people with high cholesterol are similar.

The Centers for Disease Control and Prevention (CDC) recently reported that two-thirds of US adults with high cholesterol and more than half of US adults with hypertension do not have their conditions under control.

During a press briefing to announce this information, which was derived from data taken from the National Health and Nutrition Examination Survey (NHANES), CDC Director Thomas R. Frieden, MD, MPH, said that “the bottom line is that high blood pressure and high cholesterol are out of control for most Americans who have these conditions. Although there has been progress in the past decade, it hasn't been nearly enough. About a third of adults have high blood pressure and half of those who have high blood pressure don't have it under control. And about a third of adults also have high cholesterol and two thirds of those don't have it under control. In fact, about 100 million US adults, nearly half of all adults in this country, 47%, have either high cholesterol or high blood pressure.”

Frieden noted that the proportion of Americans whose high cholesterol is adequately controlled has increased in recent years from about 15% to nearly 33% now. He also said that this report’s take-home message for doctors is that “Controlling blood pressure and cholesterol is one of, if not the, most important thing you can do for your patients. There are systems that get levels of control that are quite high. As any practicing doctor should know what proportion of your patients have high blood pressure and cholesterol, what proportion of them have it under control and what can be done to help those not yet under control.”

The CDC also reported 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.”

“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,” said Frieden.

The CDC Vital Signs report “Prevalence, Treatment, and Control of High Blood Pressure and High Cholesterol” revealed that:

• More than 80% of people who don't have their blood pressure or cholesterol under control actually have health insurance. Not only do individuals need to be continually checked for these conditions, they also need good, affordable treatment along with regular follow-up care.
• Many people don't have regular access to medical care, prescription medications, or lifestyle counseling. Some people don't go back to the doctor when they should. This makes it difficult to control their blood pressure and cholesterol. About 1 in 2 adults stops taking cholesterol medicine.
• Improvements in the way health care is delivered are needed. Clinical services that detect and control high blood pressure or cholesterol are not being delivered to all those in need. Changes in how we reimburse for and provide health care services can improve health by giving more people access to treatment.
• People get 77% of their sodium (mostly salt) from eating processed or restaurant foods, which can raise blood pressure. Even people who want to eat low-salt foods may have trouble finding them in grocery stores or on restaurant menus.
• Trans fat found in fried and processed foods such as cookies and donuts can raise cholesterol, contributing to heart disease and stroke. Only 1 in 5 Americans lives where there are policies that eliminate artificial trans fat from restaurant foods.
• Everyday decisions can help keep a heart healthy. These include not smoking, eating right, exercising, and taking prescription medicines. Policies that make it easier for people to eat a healthy diet, walk or bicycle for transportation or fun, and have smoke-free areas can help lower blood pressure and cholesterol.