Insurance status influences hypercholesterolemia, hypertension treatment

24 August 2010

MedWire News: Hypercholesterolemia and hypertension are less likely to be treated or controlled in US citizens if they do not have health insurance, researchers report.

The team says that increasing the proportion of people with health insurance could be a way to improve the management of these common cardiovascular risk factors, and reduce health disparities.

The lack of health insurance is a large and growing problem in the USA with 15.4% of the population uninsured in 2008, note Daniel Levy (Framingham Heart Study, Massachusetts, USA) and colleagues.

They examined the repercussions of this among 6098 participants in the Framingham Heart Study, aged 19 to 64 years, who attended the seventh Offspring cohort examination cycle between 1998 and 2001, or the Third Generation cycle from 2002 to 2005.

At the time of their clinical examination, 3.8% of the participants were uninsured, the researchers report in the American Journal of Medicine

The prevalence of elevated low-density lipoprotein (LDL) cholesterol or hypertension was similar, regardless of whether or not a person was insured. However, the proportion of people that obtained treatment and achieved control of these CV risk factors was lower among the uninsured than the insured.

Specifically, uninsured men were significantly less likely than those who were insured to receive treatment or control of elevated LDL cholesterol, with corresponding odds ratios (ORs) of 0.12 and 0.17.

Uninsured men and women were also significantly less likely to be treated for hypertension, with ORs of 0.19 and 0.31, respectively.

“Whereas the lower rate of hypertension control in the uninsured has been demonstrated, the finding that the proportion of controlled hypercholesterolemia also is significantly lower in uninsured men than insured men is new,” the researchers say.

Levy et al conclude: “Our investigation emphasizes the relations between insurance status and cardiovascular disease risk factor prevalence, treatment, and control.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Am J Med 2010; 123: 741–747