The impact of hypertension (high blood pressure) on commercially insured americans

A study based on the BCBS Health Index

HYPERTENSION  health impact ACROSS THE NATION

The BCBS Health Index shows that among over 200 health conditions hypertension has the greatest impact on quality of life and longevity for commercially insured Americans.
LOW IMPACT HIGH IMPACT

HYPERTENSION health impact PREVALENCE

People who have hypertension are also more likely to have other chronic and cardio-related conditions

Full population
Those with hypertension

2016 Prevalence of Select Conditions

70%
60%
50%
40%
30%
20%
10%
0%
23%
2.7 x More Likely
63%
High
Cholesterol
7%
3.6 x More Likely
25%
Type 2 Diabetes
4%
3.5 x More Likely
14%
Coronary
Artery Disease
1%
5 x More Likely
5%
Stroke
1%
5 x More Likely
5%
Heart
Failure
70%
60%
50%
40%
30%
20%
10%
0%
23%
2.7 x More Likely
63%
High
Cholesterol
3.6 x More Likely
25%
Type 2 Diabetes
4%
3.5 x More Likely
14%
Coronary
Artery Disease
70%
60%
50%
40%
30%
20%
10%
0%
1%
5 x More Likely
5%
Stroke
1%
5 x More Likely
5%
Heart
Failure
Full population
Those with hypertension

HYPERTENSION prevalence MEN vs WOMEN

Men suffer from hypertension more than women

2016 Hypertension Prevalence

0
5%
10%
15%
20%
25%
24%
20%
Percent of adverse health due to hypertension

Therefore, men are at greater risk for several other cardiovascular conditions.

Women
Men

Health Impact by Condition

20%
15%
10%
5%
0%
0%
5%
10%
15%
20%
11%
Hypertension
5%
Coronary
Artery Disease
1%
Heart Failure
1%
Stroke
15%
Hypertension
10%
Coronary
Artery Disease
2%
Heart Failure
1%
Stroke
0%
5%
10%
15%
20%
15%
Hypertension
10%
Coronary
Artery Disease
2%
Heart Failure
1%
Stroke
0%
5%
10%
15%
20%
11%
Hypertension
5%
Coronary
Artery Disease
1%
Heart Failure
1%
Stroke
Women
Men

Hypertension increases with age

Although the lowest prevalence for hypertension is among millennials (18-34 year olds) – hypertension is growing fastest in this age group.

2014
2016

Change in prevalence of hypertension by age group from 2014 to 2016

60%
50%
40%
30%
20%
10%
0%
+19%
5%
6%
18-34
+11%
18%
20%
35-44
+8%
32%
35%
45-54
+5%
49%
51%
55-64
60%
50%
40%
30%
20%
10%
0%
+19%
5%
6%
18-34
+11%
18%
20%
35-44
60%
50%
40%
30%
20%
10%
0%
+8%
32%
35%
45-54
+5%
49%
51%
55-64
2014
2016

HYPERTENSION health impact BY REGION

Hypertension impacts various regions of the country to differing degrees.

LOW IMPACT HIGH IMPACT
-30%
0%2016 National
Average
30%
-4%
New England
-7%
Midwest / Plains
-29%
Mountain
-26%
Pacific Northwest
-23%
Southwest / California
-12%
Upper Midwest
9%
Central South
8%
New York Metro
7%
Mid-Atlantic
24%
South East
0%
30%
-29%
Mountain
-26%
Pacific Northwest
-23%
Southwest / California
-12%
Upper Midwest
-7%
Midwest / Plains
-4%
New England
0%
30%2016 National
Average
7%
Mid-Atlantic
8%
New York Metro
9%
Central South
24%
South East
LOW IMPACT HIGH IMPACT

HYPERTENSION health impact BY COUNTY TYPE

Hypertension has a higher toll on health in rural and suburban counties, especially among young adults.

Low impact
High impact
-20%
0%2016 National
Average
20%
-13%
-17%
Urban / MSA
-4%
-8%
Suburban
7%
12%
Rural
-20%
0%2016 National
Average
-13%
-17%
Urban / MSA
-4%
-8%
Suburban
o%
20%
7%
12%
Rural
All ages
18-34
All ages
18-34

HYPERTENSION health impact BY INCOME LEVEL

The impact of hypertension is greater in lower-income counties.

2016 Hypertension HEALTH IMPACT by County Median Income Quintiles

50%
38%
25%
13%
0%2016
National
Average
-13%
-25%
20% of counties
with lowest income
+43%
+22%
Median income
quintile
+12%
+1%
20% of counties
with highest income
-14%

HYPERTENSION HEALTH IMPACT PHYSICAL ACTIVITY

Regions with higher levels of   physical activity  have lower impact from hypertension.
33%
25%
17%
8%
0%
-8%
-17%
-25%
-33%
70%
73%
75%
78%
80%
83%
85%
Southeast
Central South
New York Metro
Mid-Atlantic
Southwest / CACalifornia
Midwest / Plains
Upper Midwest
New England
Mountain
Pacific
Northwest
More physical activity
High impact
Low impact

2016 hypertension treatment costs

Costs (per patient per year) to treat a patient with hypertension are flat or declining.

$500
$400
$300
$200
$100
0%
Treatment costs have remained
flat for 18-34 year olds
$194
$194
18-34
$274
$261
35-44
$338
$319
45-54
Treatment costs for 55-64 year olds
show the greatest decrease (-7%)
$406
$379
55-64
$500
$400
$300
$200
$100
0%
Treatment costs have remained
flat for 18-34 year olds
$194
$194
18-34
$274
$261
35-44
$500
$400
$300
$200
$100
0%
$338
$319
45-54
Treatment costs for 55-64 year olds
show the greatest decrease (7%)
$406
$379
55-64
2014
2016

2016 hypertension treatment costs

BCBS claims data for commercially insured members showed a 28% decline in prescription drug costs for hypertension from 2014 to 2016.

2016 Cost BY TYPE OF SPENDING

Costs have remained flat for younger hypertension patients due to a lower mix of prescription drugs in treatment.
6%
6%
64%
24%
Ages 18 - 34
While prescription spending is greater for older patients, costs have actually declined due to use of lower-cost generic drugs.
2%
3%
47%
48%
Ages 55 - 64
Emergency room
In patient
Out patient
Prescription drugs
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