Prevalence, Treatment, and Control of Combined Hypertension and Hypercholesterolemia in the United States

Hypertension and hypercholesterolemia are important modifiable risk factors for cardiovascular disease (CVD). We examined the prevalence, treatment, and control of combined hypertension and hypercholesterolemia in United States adults aged ≥20 years (n = 2,864, projected to 118 million, 52% women) from the National Health and Nutrition Examination Survey 2001 to 2002 by gender, age group, ethnicity, and co-morbidities (metabolic syndrome, diabetes mellitus [DM], and preexisting CVD). Hypertension was defined as blood pressure of ≥140/90 mm Hg (≥130/80 mm Hg if DM was present) or on treatment. Hypercholesterolemia was defined as a low-density lipoprotein cholesterol level of ≥130 mg/dl (≥100 mg/dl if DM or CVD was present) or on treatment. The overall prevalence of hypertension, hypercholesterolemia, and hypertension and hypercholesterolemia combined was 30%, 47%, and 18%, respectively. The incidence of the 2 combined was 20% in women versus 16% in men (p <0.05), ranging from 1.9% in those aged 20 to 29 years to 56% in those aged ≥80 years (p <0.001). Combined hypertension and hypercholesterolemia was least prevalent in Hispanics (9.8% compared with 19% in whites and 22% in African-Americans, p <0.01) and highest in those with CVD plus DM or metabolic syndrome (69%), CVD only (44%), DM only (41%), and metabolic syndrome only (37%). Of those with combined hypertension and hypercholesterolemia, 29% were being treated (8.3% in those aged 20 to 29 years to 38% in those aged 70 to 79 years, p <0.01). Treatment was least prevalent in Hispanics (12% vs 24% in African-Americans and 30.4% in whites, p <0.01). Overall control of hypertension and hypercholesterolemia was only 9% and was low in all disease groups (5.5% to 16%). In conclusion, treatment and control of combined hypertension and hypercholesterolemia are suboptimal. Increased efforts to improve treatment of these conditions are needed.