Based on available data, the committee estimated that hypertension prevalence might be reduced by as much as 22 percent if Americans consumed less salt in their diet and ate more vegetables, fruit, and lean protein. A recent study calculated that reducing salt intake from 3,400 milligrams to the currently advised maximum intake level of 2,300 milligrams per day could bring down the number of individuals with high blood pressure by about 11.1 million and result in approximately $17.8 billion in health care cost savings annually. The committee also estimated that an initiative to help overweight and obese Americans each lose 10 pounds could reduce the prevalence of high blood pressure in the overall population by 7 percent to 8 percent. An exercise program that gets physically inactive people more active could decrease prevalence by 4 percent to 6 percent.
Efforts to get health care providers to follow current guidelines for treatment and prevention are also needed, the report says. The committee noted that lack of physician adherence to treatment guidelines for hypertension is a significant reason why many patients are unaware of their condition and do not have it under control. Data show that 86 percent of individuals with uncontrolled hypertension have insurance and visit their doctors. Since it is not clear why providers frequently do not follow the guidelines, CDC officials should research this issue as well as work with accreditation programs to improve providers' adherence to recommended treatment regimens.
Out-of-pocket costs are a significant reason why some hypertensive patients reduce or discontinue their medications, the report notes. CDC should encourage the Medicare and Medicaid programs and private insurers to find ways to eliminate or reduce deductibles and co-payments for anti-hypertensive medications and to work with the pharmaceutical industry to standardize and simplify applications for patient assistance programs that provide reduced-cost or free hypertension medications.
Source: National Academy of Sciences