On Target: What the New Hypertension Guidelines Mean

11.28.17

Nearly half of all American adults now have high blood pressure. This is according to the latest hypertension guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), which now define high blood pressure as 130/80 mmHg, down from 140/90 mmHg. As a result of this change, the total number of adults with high blood pressure is expected to increase from 72 million to 103 million.1

High blood pressure is the most significant modifiable risk factor for cardiovascular disease (CVD), which is the leading cause of death for both men and women in the U.S. It is also one of the most costly diseases. In fact, it is estimated that in 2016 the cost to treat CVD in the U.S. topped $555 billion, and by 2035 spending is expected to rise to more than a trillion dollars.2

While new guidelines mean a greater number of Americans now have elevated blood pressure, for the majority of patients, lifestyle changes will be sufficient to bring their blood pressure under control. This can include following a heart-healthy diet, reducing sodium intake, increasing regular physical exercise, weight loss and limiting alcohol intake.

In addition, the number of people requiring a prescription, such as an anti-hypertensive drug, to help manage their blood pressure will likely increase. For example, the new guideline could result in an additional 39 million blood pressure medication prescriptions each year for CVS Caremark™ pharmacy benefit management (PBM) members, taking into account that not all those who are newly diagnosed will require medication therapy.

Fortunately, the majority of drugs in this class are available as generics. Therefore, out-of-pocket costs for patients, including CVS Caremark members should be low, and the increase in cost to payors is also estimated to be relatively small. Some experts also believe that the lower blood pressure targets could encourage more people to keep their blood pressure under control, which could lead to fewer costly events such as heart attacks, strokes and hospitalizations. In fact, research shows that for every dollar spent on medication, adherence to blood pressure therapies can result in more than a $10 savings in avoidable downstream health care costs3. Based on the number of new patients who may now be on blood pressure medications under the new guidelines, that could result in a total savings of nearly $21 billion annually across the health care system.4

CVS Health Can Help

While lowering high blood pressure can help reduce a person’s risk of CVD,5 lifestyle modifications and medication therapy can be hard to manage. CVS Health can help.

For example,

  • CVS Caremark PBM members can take advantage of the Pharmacy Advisor® counseling program. This includes in-person or telephonic support from CVS pharmacists who can help answer questions about a patient’s medications or other chronic, co-morbid conditions as well as offer lifestyle management support. This can help patients stay on track with their medications, which can help to keep their blood pressure in check and under control.
  • Regular blood pressure readings are very important to help track blood pressure over time. In nearly every CVS Pharmacy™, patients can find a free blood pressure monitoring machine to help. In addition, MinuteClinic® is also a heart-healthy resource. Nurse practitioners and physician assistants can perform the five biometric screenings that can determine a patient’s risk for heart disease: total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar and body mass index. They can also answer questions about blood pressure readings and educate patients about their condition and management options. Plus, a copy of the MinuteClinic visit records can also be sent to patients’ primary care physicians, with patient permission, to help connect care and keep patients’ health records up to date.
  • CVS pharmacists also play an important role in helping patients manage their blood pressure. Pharmacists are on the front lines of health care and have frequent interactions with patients filling prescriptions for chronic conditions such as high blood pressure. They can help coordinate care with the patient’s health care providers and also offer solutions such as prescription refill reminders to encourage patients with chronic conditions to stay adherent to their medications. In fact, research shows that patients with chronic conditions who receive support from pharmacists are more likely to reach their clinical targets.6
CVS Health is a national sponsor of the American Heart Association’s Go Red For Women, an annual campaign designed to raise awareness of heart disease and stroke as the number one killer of women and to empower women to take charge of their heart health. As a sponsor, CVS Health has pledged to raise a minimum of $10 million over three years to support life-saving cardiovascular research and education.

1  https://www.nytimes.com/2017/11/13/health/blood-pressure-treatment-guidelines.html

2  https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_491543.pdf

3  http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.1087

4  CVS Health Analytic Consulting Services, 2017.

5  https://www.nytimes.com/2015/09/12/health/blood-pressure-study.html?_r=0

6  http://annals.org/aim/article/2517407/pharmacist-led-chronic-disease-management-systematic-review-effectiveness-harms-compared