Use of cholesterol and blood pressure medicines by young adults appears to be rising rapidly — at a faster pace than among senior citizens, according to an industry report being released Tuesday.
Experts point to higher rates of obesity, high blood pressure and high cholesterol problems among young people. Also, doctors are getting more aggressive with preventive treatments.
“This is good news, that more people in this age range are taking these medicines,” said Dr. Daniel W. Jones, president of the American Heart Association.
Still, he said many more people should be on the drugs that lower cholesterol or blood pressure and which have been shown to reduce risks for heart attack and stroke.
The new data, from prescription benefit manager Medco Health Solutions Inc., indicate use of cholesterol-lowering drugs among people aged 20 to 44, while still low, jumped 68 percent over a six-year period.
The rate rose from 2.5 percent in 2001 to just over 4 percent in 2006 among Medco customers. That means roughly 4.2 million Americans in that age group are now taking cholesterol medicines.
Meanwhile, use of blood pressure medicines increased 21 percent, from about 7 percent of 20- to 44-year-olds in 2001 to over 8 percent in 2006. That translates into about 8.5 million Americans in that age group taking drugs to lower their blood pressure.
“It was a surprise to us,” said Dr. Robert Epstein, chief medical officer at Franklin Lakes, N.J.-based Medco. “Maybe the fact that we’re seeing more young people with high cholesterol and blood pressure is indicative of the epidemic of obesity and overweight that we’re seeing in this country.”
Among people 65 and older, use of blood pressure drugs increased only 9.5 percent and use of cholesterol drugs by 52 percent. That’s because half the seniors were already taking blood pressure drugs and more than one in four were taking cholesterol drugs in 2001.
Jones, dean of the University of Mississippi School of Medicine, said he has seen some increase in young adults with blood pressure or cholesterol problems, but not of the magnitude suggested by Medco’s data.
Dr. Howard Weintraub, the heart disease prevention expert at the American College of Cardiology, said he’s “thrilled” by the dramatic increase, which he says is tied to requests from patients with “a brand new sense of urgency” and referrals from other doctors to his private practice.
“If you wait until a heart attack or stroke, it’s a little bit late,” Weintraub said.
He and Epstein both said patients with problems should first work with their doctors on lifestyle changes — more exercise, a better diet and weight loss. But Weintraub said many people need medication to achieve and maintain the ever-lower levels of blood pressure and cholesterol that experts now recommend.
However, Dr. John LaRosa, president of SUNY Downstate Medical Center, said, “particularly for young people, lifestyle change is worth a try.”
Once patients start taking these medicines, they usually stay with them and there are some side effects, LaRosa said.
“It’s amazing what (losing) five or 10 pounds will do” to reduce blood pressure and cholesterol levels, he said.
Federal health statistics show that while the percentage of people with high cholesterol has dropped overall in recent years, it has risen among younger people, especially those 20 to 34 years old.
Meanwhile, the prevalence of high blood pressure was flat or up slightly among those age groups; among women in the 35 to 44 age group, the rate of high blood pressure rose significantly.
Medco processes prescription claims for about 60 million insured Americans. The report’s findings are based on a representative sample of data from 2.5 million members.
Increase in use of cholesterol and hypertension medications largest among people ages 20 to 44Drop in the age of women using heart disease medications greater than men
Heart disease, high blood pressure and hardening of the arteries - conditions that are usually associated with the senior population - are creeping into young adulthood. According to new research conducted by Medco Health Solutions, Inc. , prescription drug use by younger adults for heart disease- related conditions is increasing at a rapid rate, far outpacing older adults and offering a glimpse into the forthcoming clinical and financial challenges facing the nation’s health care system.
The analysis shows that between 2001 and 2006, the number of 20-44 year olds taking prescription medications to treat high cholesterol increased 68 percent, and use of antihypertensives jumped 21 percent.
Based on this new analysis, the estimated number of 20-44 year olds nationwide on lipid-lowering drugs surged from 2.5 million in 2001 to 4.2 million in 2006, while the number of people of that age taking antihypertensives spiked from 7 million to 8.5 million in the six-year period.
“This may be both a good news, bad news story,” said Dr. Robert Epstein, Medco’s chief medical officer. “The good news is that younger patients are taking medications that control conditions that, if left untreated, could lead to heart attacks and strokes - indicating that physicians are screening patients more regularly and treating these precursors more aggressively than in the past. The bad news is that these conditions are showing up in patients at younger ages, which could be the result of the growing obesity epidemic and various lifestyle factors.”
Not only were the increases among 20-44 year olds significant, but so too were the rates of increase when compared to age groups more traditionally associated with these categories of medications. The increase in the number of 20-44 year-olds on lipid-lowering medications was 37 percent higher than it was for 45 to 64 year olds; the growth in prevalence of those on antihypertensives was 52 percent greater. When compared with patients 65 years or older, the increase in usage of lipid-lowering medications was 31 percent higher in the 20-44 group, and among those on antihypertensives it was more than double.
Decline Seen in Age of Patients on Drug Treatment
The analysis also found a significant shift downward in the age of patients using these drug treatments. In 2006, half of all patients on lipid- lowering drugs were 61 years old or younger; the median age of women fell more sharply than men, dropping from 67 to 62 in the six-year span, as compared to 62 to 59 for men.
The median age of those using antihypertensives declined four years over the six-year period, with half of all patients on these drugs being 60 years or younger in 2006; again women had the greatest decline, dropping from 65 to 60 versus men whose median age fell from 63 to 60.
“There is a history of women being under-diagnosed and under-treated for heart conditions,” said Epstein. “The fact that more women at a younger age are receiving medication treatment for high cholesterol and hypertension is a sign that the medical community is recognizing that heart disease is a serious threat to women as well as men.”
Heart Disease Risks
High cholesterol and high blood pressure are two of the leading risk factors for heart disease, heart attack and stroke. High LDL cholesterol can cause atherosclerosis, a narrowing and hardening of the arteries that feed the heart and brain. High blood pressure, or hypertension, can weaken the arterial walls and make them more prone to atherosclerosis. Both conditions can lead to blood clots that can block blood flow and result in a heart attack or stroke.
For some people with high cholesterol and hypertension, lifestyle changes such as weight loss, dietary changes and exercise can control the conditions. For others, medications may be needed. The most common medications used to treat high cholesterol are statins. To treat hypertension, diuretics, beta- blockers and ACE inhibitors are often prescribed.
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