WASHINGTON, DC—Two out of three US adults with high cholesterol and half of US adults with high blood pressure are not being treated effectively, according to CDC’s Vital Signs. “Heart disease is the leading killer in America, and the bottom line is that high blood pressure and high cholesterol are out of control for most Americans who have these conditions,” said CDC Director Thomas Frieden, MD. “Although there has been progress in the past decade, it hasn’t been nearly enough.”

The report found that those with the lowest rates of control had no health insurance. However, the report also found that more than 80% of those who have uncontrolled blood pressure or cholesterol actually have private or public health insurance. “If you don’t have health insurance, you’re much less likely to have your high blood pressure or your high cholesterol controlled,” said Frieden. “But even among people who do have health insurance, levels of control are not what they could or should be.”

Improving Blood Pressure and Cholesterol Control

To improve blood pressure and cholesterol control levels, the report suggested that a comprehensive approach is needed involving policy and system changes to improve health care access, quality of preventive care, and patient adherence to treatment.

Improvements in the way health care is delivered, including use of electronic health records with registry and clinical decision support functions, could facilitate better treatment and follow-up management, and improve patient-physician interaction, the report stated. “Improved access and quality improvement efforts might need to be particularly focused on groups for whom the prevalence of control is especially low, such as young adults and Mexican Americans.”

Poor adherence to medication regimens is another barrier to blood pressure control and might explain, in part, the low prevalence of blood pressure control observed even among patients with health insurance, according to the report. Medication costs, complicated regimens, adverse effects, and insufficient physician-patient communication are among major factors cited as associated with decreased patient adherence to medication regimens.

Heart disease, stroke, and other cardiovascular diseases are among the leading causes of death and now kill more than 800,000 adults in the US each year. 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 spent on healthcare in the US, according to CDC.

The report uses data from the National Health and Nutrition Examination Survey to examine the prevalence, pharmacologic treatment, and control of hypertension among US adults. The examination focuses on indicators of the use of medical care, as well as on demographic characteristics and socioeconomic factors.

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