High blood pressure (hypertension) and high cholesterol (hyperlipidemia) are the most prevalent risk factors for heart health that affect 68% of U.S. adults. There is also high overlap between them – 63% of people with high blood pressure also have high cholesterol.
Yet despite this prevalence, high blood pressure and high cholesterol are among the most misunderstood and mismanaged conditions: 79% of people with hypertension do not have it under control, and about half of people with high cholesterol who could take medication don’t. People often ignore their condition and may end up suffering from heart disease, which can lead to hospitalizations and – in many tragic cases – death.
To support employee health and wellness, as well as to control rising employer healthcare costs, which are projected to spike 6.5% in 2023, many organizations are addressing hypertension in their workforce. This is a positive step! However, whole-heart health, which includes measuring and monitoring cholesterol levels, may not be part of the scope of an employer’s initiatives.
Below, we highlight eight surprising connections between high blood pressure and high cholesterol. We urge employers to use this information to help shape and drive their holistic strategy for heart health in their workforce. We also recommend employers that share this data with their employees, so they can make smarter decisions regarding their health and wellness.
1. High blood pressure and high cholesterol are very common.
- Nearly 116 million adults in the U.S. have high blood pressure, which is defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg, including people who are taking medication for hypertension.
- Nearly 94 million adults in the U.S. have total cholesterol levels higher than 200 mg/dL, and 28 million adults have total cholesterol levels higher than 240 mg/dL. Total cholesterol levels under 200 mg/dl are considered healthy for adults; doctors treat readings of 200–239 mg/dL as borderline high, and readings of 240+ mg/dL as high.
2. High blood pressure and high cholesterol are linked to a higher risk of cardiovascular disease.
- High blood pressure can cause damage to arteries by making them less elastic. This decreases the flow of blood and oxygen to the heart, and can lead to cardiovascular disease – the leading cause of death for men, women, and most racial and ethnic minority groups in the U.S.
- High cholesterol can build up in the walls of the arteries. Over time, this buildup causes hardening of the arteries (known as atherosclerosis). Arteries that feed the heart can narrow in certain areas, and slow blood flow to part of the heart muscle. If blood vessels get completely blocked, then the result is a heart attack.
3. High blood pressure and high cholesterol are linked to a higher risk of stroke.
- High blood pressure can cause blood vessels to the brain to become narrow, blocked by a clot (ischemic stroke), and/or burst (hemorrhagic stroke). If this happens, part of the brain no longer gets essential blood and oxygen – and therefore starts to die. Severe strokes may cause paralysis or death.
- High cholesterol plaques can also narrow certain arteries that lead to the brain. If a vessel carrying blood to the brain is blocked completely, the result could be a stroke.
4. High blood pressure and high cholesterol are known as “silent killers.”
- Most of the time, high blood pressure has no obvious symptoms to indicate that anything is wrong.
- High cholesterol does not present any symptoms, and the only way for individuals to know if their levels are safe or unsafe is through a blood test. Research has found that 66% of people who’ve had acute ischemic strokes were unaware that they had high cholesterol.
5. High blood pressure and high cholesterol affect women and men differently.
- Research has found that women’s blood vessels age faster than men’s, which means that a 30-year-old woman with high blood pressure is more likely to develop cardiovascular problems than a 30-year-old man.
- Generally, women have higher levels of HDL cholesterol (i.e., “good cholesterol”) than men due to the female sex hormone estrogen. However, at menopause many women experience a rise in LDL cholesterol (i.e., “bad cholesterol”) and a fall in HDL cholesterol. This is why women who had healthy cholesterol values in the past may end up with elevated cholesterol later in life.
6. High blood pressure and high cholesterol put a financial strain on individuals.
- Adults with high blood pressure are estimated to pay almost $2,000 more in annual healthcare costs vs. those without high blood pressure.
- Research found that 69% of patients who were initially prescribed a PCSK9 inhibitor – injectable drugs designed to lower cholesterol levels – received the therapy. The main reason for the low usage? The patients could not afford copays of more than $300 per month for therapies that initially cost about $14,000 per year. While the price of these medications has dropped significantly in the past 3 years, there may still be financial barriers to care for many individuals.
7. High blood pressure and high cholesterol put a financial strain on employers.
- On average, an employee with cardiovascular disease costs his/her employer nearly 60 hours and over $1,100 more in lost productivity per year, compared to an employee without cardiovascular disease.
- Cardiovascular disease is consistently among the top three drivers of employee healthcare costs.
8. High blood pressure and high cholesterol put a financial strain on the healthcare system.
- Heart disease costs the U.S. about $219 billion each year, which represents about one in every six healthcare dollars. This total includes the cost of healthcare services, medications, and premature death.
- By 2030, annual direct medical costs associated with cardiovascular diseases are projected to rise to more than $818 billion
Managing Whole-Heart Health
What is the key takeaway for employers? They need to support whole-heart health for their employees.
One way that employers can achieve this goal is by providing their employees with a digital therapeutic that empowers them to manage high blood pressure and high cholesterol – the leading risk factors for heart disease.
Launched recently, Hello Heart’s ‘My Cholesterol’ feature provides users with clarity on their cholesterol and triglycerides trends through personalized insights and coaching to help them manage their cholesterol levels.
Hello Heart’s digital coaching app provides gender-specific ranges to help employees understand if their cholesterol levels are in a risky range based on their gender at birth. This unique aspect is critical, given that many ranges and general explanations fail to take gender differences into account.
In addition, employees can import lab results, store medical data from multiple sources directly in the app, and view a simple graph of the data to clearly understand trends over time.
Hello Heart is not a substitute for professional medical advice, diagnosis, and treatment. You should always consult with your doctor about your individual care.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)