Poor blood-pressure control puts 5 million older Americans at risk

Some 5 million Medicare Part D enrollees age 65 and older are not taking their blood pressure medicine properly, increasing their risk of heart disease, stroke, kidney disease, and death, according to a new Vital Signs report from the Centers for Disease Control and Prevention (CDC). Medicare Part D is a federal program that helps Medicare beneficiaries with the costs of prescription drugs and prescription drug insurance premiums.

Seven out of 10 U.S. adults ages 65 and older have high blood pressure (140/90mmHg or higher), but nearly half do not have their blood pressure under control. The report outlines the dangers of high blood pressure and the important role health care systems play in helping patients take blood pressure medicines as directed.

“A simple action can avoid potentially deadly consequences: take your blood pressure medicine as prescribed,” said CDC Director Tom Frieden, M.D., M.P.H. “Health care providers can make treatment easier to help people keep their blood pressure controlled.”

Disparities in taking blood pressure medicine as directed

The report analyzes data from more than 18.5 million people enrolled in Medicare Advantage or Original Medicare with Medicare Part D prescription drug coverage during 2014. CDC and the Centers for Medicare & Medicaid Services (CMS) researchers looked at disparities in beneficiary adherence rates based on factors including geography, race/ethnicity, gender, income status, and medication class.

Key findings in the Vital Signs report include:

• About 5 million Medicare Part D enrollees ages 65 or older are not taking their blood pressure medicine as directed. This means they may skip doses or stop taking it altogether.
• The percentage of Medicare Part D enrollees not taking their blood pressure medicine is higher among certain racial/ethnic groups (American Indian/Alaska Native, Black, Hispanic). This contributes to these groups’ higher risk of heart attack, stroke, kidney disease, and death.
• There are also geographic differences. Southern U.S. states, Puerto Rico, and the U.S. Virgin Islands have the highest overall rates of not taking blood-pressure medicines as directed. North Dakota, Wisconsin, and Minnesota have the highest rates of people who do take their medicine as directed.

CDC Efforts to Reduce the Prevalence of Uncontrolled Hypertension

Health care systems—including doctors, nurses, pharmacists, community health workers, practices, hospitals, and insurers—can play a key role in improving blood pressure control nationwide. CDC encourages health care systems to ensure that people understand the importance of blood pressure control and how taking blood pressure medicine as directed along with a healthy diet and exercise lowers risk of heart disease, kidney disease, and stroke.

The federal government is also providing resources to all states and Washington, D.C., to prevent chronic disease, including heart disease and stroke; helping states track medication adherence; and encouraging prescription drug plans to improve medicine use through the Medicare Star Ratings program.

“While the Medicare prescription drug program has increased the affordability and accessibility of prescription drugs, more can be done to encourage Medicare beneficiaries to take their medications as directed,” said Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. “Medicare will continue to work with prescription drug plans to educate enrollees about the importance of taking their blood pressure medications as prescribed so that they can lower their risk for heart disease and stroke.”

To learn more about heart disease and stroke, visit https://www.cdc.gov/heartdisease and https://www.cdc.gov/stroke. For more information on high blood pressure, visit https://www.cdc.gov/bloodpressure.

Visit millionhearts.hhs.gov to read about Million Hearts, a national initiative to prevent 1 million heart attacks and strokes by 2017. To learn how professionals and practices have controlled the blood pressure of at least 70 percent of their hypertensive patients, visit http://millionhearts.hhs.gov/partners-progress/champions/index.html.

About Vital Signs

Vital Signs is a report that appears as part of the CDC’s Morbidity and Mortality Weekly Report. Vital Signs provides the latest data and information on key health indicators: cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care-associated infections, cardiovascular health, teen pregnancy, food safety, and viral hepatitis.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES