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CDC findings highlight continued need for better control of hypertension, LDL

CDC. MMWR. 2011;60:1-6.
CDC. MMWR. 2011;60:7-12.

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Two analyses have found that more than half of those with hypertension in the United States need to have it controlled, and despite improvements, LDL control still remains low. The findings were published in a February release of the CDC’s Morbidity and Mortality Weekly Report.

Hypertension controlled in nearly half of adults

The CDC’s look into hypertension prevalence began with data from the National Health and Nutrition Examination Survey that included 68 million US adults (age >18 years) with hypertension during the 2005-2008 survey period. Hypertension was defined as systolic/diastolic BP of at least 140 mm Hg/90 mm Hg, with less than 140 mm Hg/90 mm Hg defined as controlled hypertension.

Of the study population, 48 million (70%) were receiving pharmacological treatment, with hypertension controlled in 31 million (46%). Populations with hypertension noted for having a low percentage of BP control included those without a usual source of medical care (12%) and those without insurance (29%). Control prevalence was also low in young adults (aged 18-39 years; 31%) and Mexican Americans (37%). Although no changes in the prevalence of hypertension from the 1999-2002 survey period were reported, the CDC said there were significant increases in treatment and control.

Room for more improvement in LDL control

For its analysis of LDL control, the CDC also examined data from the 1999-2002 and 2005-2008 survey cycles of NHANES. The final population from the 2005-2008 cycle included an estimated 71 million US adults aged at least 20 years who had high LDL, as stated in the National Cholesterol Education Program – Adult Treatment Panel III primary prevention guidelines.

According to CDC’s data, 34 million adults (48.1%) had their LDL treated while 23 million (33.2%) had it controlled. Although at a treatment rate roughly 22% lower compared with hypertension, LDL treatment increased nearly 20% compared with 6 years earlier, suggesting a “striking” improvement in the prevalence of treatment and control. Despite this, the CDC said more must be done about the estimated one-third of Americans with high LDL, of which only one-third are controlled.

Other data of note from the analysis were the low prevalence of LDL control among those who reported receiving medical care less than twice in the previous year (11.7%), having income below the poverty level (21.9%), as well as those who were uninsured (13.5%) or Mexican American (20.3%).

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