Control of Cardio Risk Factors Lags
TODD NEALE, Staff Writer - MedPage Today


Although U.S. adults have done a better job controlling hypertension and LDL cholesterol in recent years, most still are not treated to recommended targets, according to the CDC.

About one-third of U.S. adults had high blood pressure and a similar proportion had elevated LDL cholesterol levels, researchers from the CDC's Division for Heart Disease and Stroke Prevention reported online in Morbidity and Mortality Weekly Report.

And 30% of those with hypertension and 51.9% of those with high LDL cholesterol did not receive any treatment for their conditions, resulting in control rates of less than 50% (46% for high blood pressure and 33.2% for high cholesterol), according to data from the 2005-2008 wave of the National Health and Nutrition Examination Survey (NHANES).

The CDC researchers identified certain demographic groups that had the lowest rates of control, including those:

* With no health insurance
* With no usual source of medical care
* Who had received care less than twice in the previous year
* Living below the poverty level
* Younger adults
* Mexican-Americans

Although prevalence of hypertension did not change between the 1992-2002 NHANES wave and the 2005-2008 one, control of both LDL cholesterol and hypertension improved, but, according to Thomas Frieden, MD, MPH, director of the CDC, the improvement "hasn't been nearly enough."

On a conference call with reporters, he noted that even though more than 80% of U.S. adults with uncontrolled hypertension and high LDL cholesterol have health insurance, there are still an estimated 100,000 deaths from the two conditions annually that could be prevented with low-cost, effective treatments.

He said that health insurance is important -- but not sufficient -- to improve control of the two conditions, and that other actions can be taken.

For instance, he said, the Affordable Care Act provides coverage for blood pressure and cholesterol screening with no cost sharing.

Other measures include adopting electronic health records to facilitate better treatment and follow-up, focusing clinical attention on control using standardized protocols, supporting patients and reducing barriers to adherence, and making sure nurses, pharmacists, and other allied health professionals are an important part of the healthcare team, he said.

Frieden said individuals can also do better knowing their numbers and ensuring that they are within target ranges and by eating healthier foods.

He noted that a reduction in daily sodium intake from 3,400 mg to 2,300 mg would prevent 11 million people from developing hypertension and would save $18 billion in healthcare costs.

Avoiding trans fats and other dietary changes could reduce high LDL cholesterol levels, he added.

Frieden also emphasized the importance of exercise and said that initiatives like Let's Move can decrease obesity rates, and, with them, rates of hypertension and high LDL cholesterol.