Online-only: Americans must take better control of risk factors for cardiovascular disease, report finds
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* Teddi Dineley Johnson

The majority of U.S. adults with high cholesterol and about half of adults with high blood pressure do not have their conditions under control, according to a new report. And despite the relatively low cost and proven effectiveness of treatments for these common and preventable — but potentially deadly — conditions, many Americans are not following through with them.

Released in February as a Centers for Disease Control and Prevention “Vital Signs” report, “High Blood Pressure and Cholesterol Out of Control” found that two out of three U.S. adults with high cholesterol and about 50 percent of adults with high blood pressure are not being treated effectively and are therefore at increased risk for heart attacks, strokes and other problems.

“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,” said CDC Director Thomas R. Frieden, MD, MPH. “We need to do a better job improving care and supporting patients to prevent avoidable illness, disability and death.”

Americans with the lowest rates of control had no health insurance, no usual source of medical care or had income below the poverty level. But the low uptake of treatment cannot be pinned on poverty alone, as the report also noted that more than 80 percent of Americans whose blood pressure or cholesterol is not under control actually have private or public health insurance.

“Some people don’t go back to the doctor when they should,” the report said. “This makes it difficult to control their blood pressure and cholesterol. About one in two adults stops taking cholesterol medicine.”

High blood pressure and cholesterol are major risk factors for heart attacks, strokes and related vascular diseases, which kill more than 800,000 Americans each year — 150,000 of whom are younger than age 65, according to the CDC report. Cardiovascular disease also takes a toll on the nation’s pocketbook, ringing up a nearly $300 billion bill each year in direct medical costs, the report said.

The report urges Americans with high blood pressure or high cholesterol to follow their health care providers’ instructions and stay on their medications to keep the conditions under control. The report also urges patients to improve their heart health by eating a diet that is low in total fat, saturated fat and cholesterol, rich in fruits and vegetables and low in salt. The report points out that about 77 percent of the sodium in Americans’ diets comes from eating processed or restaurant foods, which can raise blood pressure.

The report also stressed the importance of a healthy level of exercise, such as taking three brisk 10-minute walks a day, five days a week.

The report calls on health professionals to manage high blood pressure and high cholesterol at every patient visit and to remind patients about follow-up care. Moreover, policy-makers should develop policies that reward effective disease prevention and chronic disease management and develop policies that allow other health care professionals to have a more active role in managing high blood pressure and cholesterol.

To download “High Blood Pressure and Cholesterol: Out of Control,” visit [www.cdc.gov/vitalsigns](http://www.cdc.gov/vitalsigns).

*   Copyright The Nation’s Health, American Public Health Association