Cardiovascular Conditions
Cardiovascular Disease
According to the American Heart Association “An estimated 80,000,000 American adults (one in three) have one or more types of cardiovascular disease (CVD), of whom 38,100,000 are estimated to be age 60 or older.” Data from the Framingham Heart Study indicate that the lifetime risk for CVD is two in three for men and more than one in two for women at age 40. Cardiovascular disease is the leading cause of death in the United States.
Cholesterol Management for Patients with Cardiovascular Conditions
Cholesterol management is very important in the prevention and control of coronary artery disease, the leading cause of death in the United States. Approximately 452,300 deaths occur each year because of complications of this disease and many clinical studies have shown that high blood cholesterol levels are directly related to the development of coronary artery disease. Over 35% of adults over 18 have high cholesterol and less than half of persons who qualify for treatment are receiving it.
Elevated cholesterol levels can be lowered through a combination of lifestyle changes including a low-fat diet, increased physical activity and, when appropriate, treatment with cholesterol-lowering medications. Physicians routinely screen patients for high cholesterol. It is especially important for those who have already had a cardiac event such as a heart attack, bypass surgery, or coronary angioplasty to ask their doctors about treatment choices.
LDL-C screening reports the percentage of health plan members discharged from the hospital following a heart attack, bypass surgery, or coronary angioplasty, who had evidence of an LDL-C screening during the year after their hospital discharge.
LDL-C level <100mg/dL reflects the percentage of patients with known heart disease who have their cholesterol levels under control. Control for this measure means an LDL cholesterol level less than 100mg/dL. Controlling LDL cholesterol levels is very important in patients with existing heart disease and can help reduce the risk of a second heart attack by as much as 40 percent.
Controlling High Blood Pressure
The American Heart Association estimates that 72 million Americans have high blood pressure or nearly one in every three adults. Nearly one-third of these people don’t know they have it. High blood pressure can lead to numerous life-threatening conditions including heart disease, stroke and kidney failure, the number one, number three and number nine causes of death in the U.S. Lowering the blood pressure, even in amounts as small as 5-6mm, has many benefits, including decreased overall risk of developing serious medical problems. In elderly patients where the incidence of congestive heart failure is common, aggressively treating hypertension can reduce coronary heart disease and deaths from stroke.
Hypertension is defined as blood pressure readings consistently higher than 140/90. This measure looks at whether blood pressure was controlled in adults aged 18-85 years of age who have diagnosed hypertension. Adequate control was defined as a blood pressure of lower than 140/90 mmHg. Hypertension can improve with changes in diet and lifestyle, including increased exercise and the appropriate use and monitoring of medications. With careful, individualized treatment, up to three-quarters of patients diagnosed with hypertension can achieve and maintain adequate blood pressure control. Health plans can use educational programs and newsletters to increase provider and member awareness of the benefits of controlling high blood pressure.
Persistence of beta Blocker Treatment after Heart Attack
Heart attacks, also known as acute myocardial infarctions or AMI, occur in approximately 1.2 million Americans each year. Unfortunately, patients who have had a heart attack are at higher risk than the general public to have another one.
Medications called beta blockers are an important part of follow-up treatment after a heart attack. When taken shortly after a heart attack by patients without other heart problems, beta blockers can help prevent another heart attack by lowering blood pressure and decreasing how hard the heart has to work. Long term administration of beta blockers following a heart attack has been shown to improve survival and reduce the risk of future heart attacks.
While beta blockers were appropriately prescribed to over 93.5% of heart attack patients in 2002, evidence suggests that fewer than half of patients still took these medications six months later. This measure shows the rates at which patients stay on beta blocker therapy for the six months following a heart attack.
This measure calculates the percentage of members 18 years and older who were discharged from the hospital with a diagnosis of a heart attack and who received beta-blocker treatment for 6 months after the discharge.
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