ORLANDO, FLA. — More than 12% of U.S. adults have uncontrolled comorbid hypertension and dyslipidemia, and an estimated 1 in 10 of these individuals are expected to experience a coronary heart disease event within 4 years, David Klingman, Ph.D., reported at the annual meeting of the American College of Cardiology.
That's 1.76 million people who will have coronary death, a nonfatal MI, or unstable angina. Estimated first-year direct medical costs of these CHD events is $10.5 billion, according to Dr. Klingman, director of health economics at ValueMedics Research LLC of Arlington, Va.
But nearly half of these CHD events—and the attendant economic burden on the health care system—would be avoidable through identification and treatment to goal of all individuals with uncontrolled comorbid hypertension and dyslipidemia, he added.
His Pfizer-supported study used data from the third National Health and Nutrition Examination Survey (NHANES III). Extrapolating from the findings in nearly 8,000 survey participants, he concluded that nearly two-thirds of Americans with hypertension have dyslipidemia as well.
Moreover, an estimated 17.9 million adults have uncontrolled comorbid hypertension and dyslipidemia.
Next, Dr. Klingman and coworkers added up the various cardiovascular risk factors present in each member of the NHANES III cohort. The mean age was 61.8 years, and 57% were men. Then they utilized the Framingham risk equations to determine the mean 4-year risk of a CHD event. That risk was 9.8% among individuals with uncontrolled comorbid hypertension and dyslipidemia, compared with just 1% among those with neither condition, he told this newspaper.
The 4-year CHD risk was 4.8% among individuals with uncontrolled hypertension alone, and 4.7% in normotensive individuals with uncontrolled dyslipidemia.
Breaking the data down demographically, the 4-year risk was lowest among dual-risk women aged 20–44 years, at just 3.0%. The highest 4-year risk, at 23%, was in men aged 75 or older with comorbid hypertension and dyslipidemia. That translates into more than 321,000 expected CHD events among men aged beyond 75.
The NHANES III data strongly suggest an intensive screening and treatment effort targeted at dual-risk individuals would be cost effective, the analyst said.