The Time to Act is Now: The Toll of High Blood Pressure
More than 100 million American adults have high blood pressure (a reading of 130/80mm Hg or higher) but only about half actually have the condition under control. High blood pressure was linked to 70% of all major cardiovascular events in the U.S. and deaths from high blood pressure are on the increase; between 2009 and 2019, deaths attributed to high blood pressure rose 65%. Cardiovascular-related disease costs the health care system hundreds of billions of dollars a year that could be avoided with more effective high blood pressure prevention and management.
The toll that high blood pressure takes on communities of color is particularly significant. The rate of high blood pressure for Black and African American adults in the U.S. is among the highest in the world, 57% for males and 55% for females. In 2019, high blood pressure was attributed to 57% of deaths of Black and African American males and 39% of Black and African American females compared to 26% for White males and 20% of White females. In addition to the loss of life, there are substantial financial costs related to high blood pressure. Between 2017 and 2018, the direct and indirect cost of heart and stroke-related diseases was an estimated $378 billion in the U.S. Given these facts, it’s not surprising that U.S. Department of Health and Human Services Secretary Alex M. Azar II called high blood pressure a “threat to our health” and said, “the time to act is now.”
Providing at-home blood pressure monitors is considered a cost-effective means to help patients determine their blood pressure. To understand the prevalence of at-home blood pressure monitors as a benefit in health insurance plans for Washington residents, the Washington State Department of Health engaged the Washington Health Alliance to conduct a survey of current practices and create an Issue Brief on the topic.
The survey was distributed to 35 Washington state employers had a 38% completion rate. Collectively, they cover more than 430,000 lives. Survey results provided insights and a deeper understanding of the problem of high blood pressure:
- 50% reported that they were unaware of the prevalence of hypertension;
- 67% do not consider hypertension a high priority that needs to be addressed in their workplace; and
- 75% had not provided any blood pressure-focused education to their employees within the last two years.
In addition, the survey found that several employers include at-home blood pressure monitors as a pre-deductible benefit and
- 89% do not cap at-home blood pressure monitor coverage. Those that do cover a maximum of 50% of the costs.
- 75% provide access to the device via a prescription.
- 67% do not require a co-payment for at-home blood pressure monitors. If required, the co-payment is typically 20%;
- 60% of PPO and HMO insurance plans cover at-home blood pressure monitoring devices.
- 33% of policies provide the benefit to all members, the others that provide the benefit require a diagnosis of medical necessity, cardiovascular disease, hypertension or an in-office blood pressure reading of 130/80mm Hg or higher.
The Issue Brief makes several recommendations for Washington employers to help reduce the prevalence and devastating effects of unmanaged blood pressure, including:
- the impact of hypertension on the health of their employees and families;
- the importance of recognizing and managing high blood pressure, so appropriate care can be provided;
- support for employees who may be at risk for cardiovascular-associated adverse medical events; and
- adding home blood pressure devices to health benefits with no cost-sharing.
This project was supported by funds from the Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention.
Published: June 30, 2022