High Blood Pressure and Cholesterol Not Adequately Treated in the USA

High blood pressure (hypertension) effects one in 3 US adults and contributes to one in 7 deaths. The Centers for Disease Control and Prevention (CDC) analyze available data on the prevalence, treatment, and control of hypertension in the USA at regular intervals. Their latest report, which has just been issued, covers the years 2005 - 2008. It shows that two-thirds of all US adults with hypertension are not getting effective treatment, even though 80% of them have the necessary health insurance to allow them to do something about it.

Hypertension was defined as blood pressure equal or above 140/90 mm Hg or current antihypertensive drug therapy. The prevalence of the disease had not changed much from that in an earlier analysis, using the period 1999 - 2002; it went from 28.1% to 30.9%. However, the prevalence of antihypertensive therapy among those with hypertension rose significantly, from 60.3% to 69.9%, which was accompanied by an improved rate of blood pressure control – this went from 33.2% to 45.8%.

Of the 68 million adults with hypertension, 70% were receiving pharmacologic treatment but only 46% had their condition under control. It was disturbing to find that 86% of adults with uncontrolled blood pressure had adequate medical insurance. However, the groups with the lowest rates of drug therapy were younger (18 to 39), lacked a consistent source of medical care, and lacked health insurance. Mexican-Americans were the ethnic group with the lowest control rates (36.9%).

The CDC has issued a similar report dealing with the state of raised low-density-lipoprotein cholesterol (LDL-C) in the USA, comparing the same periods. While the prevalence of raised LDL-C didn't change significantly from 1999 - 2002 (34.5%) to 2005 – 2008 (33.5%), treatment rose from 24.4% to 48.1%. The reasons for low treatment rates were similar to those for non-treatment of hypertension, for the most part.

The CDC reports on hypertension and raised LDL-C both conclude that better control of these risk factors will only be achieved through a comprehensive response from multiple sectors of society – federal, state, and local governments, healthcare providers, employers, food and restaurant industries, and the pharmaceutical industry. However, I think that people themselves, given all the health information available today, should assume the bulk of responsibility for their own care, and try harder to obtain and make use of readily-available therapies. After all, they are the ones who ultimately suffer the consequences of ignoring these risk factors.