POPULATION AWARENESS AND CONTROL OF HYPERTENSION AND HYPERCHOLESTEROLEMIA - THE ATHEROSCLEROSIS RISK IN COMMUNITIES STUDY

Background: A national program for hypertension detection and control was implemented in the 1970s, whereas a similar program for control of hypercholesterolemia has been implemented in recent years. We studied the levels of awareness, treatment, and control of these conditions i n US population samples during a 3-year period (1987 to 1989). Methods : The levels of awareness, treatment (by medication), and adequate con trol of hypertension (systolic blood pressure, greater than or equal t o 140 mm Hg; diastolic blood pressure, greater than or equal to 90 mm Hg; or antihypertensive medication) and hypercholesterolemia (serum ch olesterol level, greater than or equal to 6.21 mmol/L [greater than or equal to 240 mg/dL], or lipid-lowering medication) were studied among participants in the baseline examination of the Atherosclerosis Risk in Communities Study, including 15 739 individuals aged 45 to 64 years . Results: Eighty-four percent of the hypertensive subjects and 42% of the hypercholesterolemic subjects were aware of their conditions. Ove rall, 50% of the hypertensive subjects and only 4% of the hypercholest erolemic subjects had their conditions both treated and controlled. Ra tes of hypertension prevalence, awareness, and control remained stable during the 3-year study period. Hypercholesterolemia prevalence decre ased from 30% in 1987 to 25% in 1989; its awareness increased from 31% to 50% during the same period. Hypertensive women were more likely th an hypertensive men to be aware and treated, whereas hypercholesterole mia awareness was higher in men than in women. Hypertension awareness was highest in black women, but black hypertensive subjects were less likely than whites to be treated and to have their hypertension contro lled. Black hypercholesterolemic subjects were less likely to be eithe r aware or treated. Conclusions: After the recent implementation of th e National Cholesterol Education Program, the levels of awareness, tre atment, and control of hypercholesterolemia are improving at a high ra te, although they are still substantially lower than those for hyperte nsion. Further improvement is necessary, particularly among certain po pulation groups, such as blacks.