Institute of Medicine to be congratulated for calling more resources to fight hypertension

The following is an opinion piece released today by the National Forum for Heart Disease and Stroke Prevention:

The Institute of Medicine is to be congratulated for sounding the call for more resources to fight hypertension (high blood pressure), the number two preventable cause of death and a leading contributor to heart disease and stroke. Heart disease and stroke are the number one and three overall causes of death of individuals in the United States.

It is almost inconceivable that CDC's Division of Heart Disease and Stroke Prevention is funded at a modest $54.1 million to support activities for not only hypertension, but also stroke and cardiovascular disease in general. This funding level is astonishing in light of the fact that hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. Prevalent in adults and endemic in older Americans, hypertension is a major contributor to cardiovascular morbidity and disability.

Numerous studies have been conducted which prove that hypertension is relatively easy to prevent, diagnose, and treat.  Clearly, what stands in the way of addressing the hypertension epidemic is not the lack of knowledge, but the absence of a collective will to allocate resources for national, state and local interventions.

The IOM report, A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension, released Monday, reiterates the repeated call that CDC's CVD program is dramatically underfunded and makes the recommendation that "Congress give priority to assuring adequate resources for implementing a broad suite of population-based policy and system approaches at the federal, state and local levels that have the greatest promise to prevent, treat, and control hypertension." Only adequate funding will deliver the nation from the impact of hypertension. In most states, current levels of funding make it almost impossible to develop a program that will make any meaningful impact, especially in health disparate communities.

One of the key investment areas must be the funding of surveillance systems that track, measure the impact and allow for reporting of hypertension cases. As noted in the report, hypertension provides one of the most compelling conditions justifying the creation of a state and local NHANES-like survey providing representative population-based objective clinical information. Accurate information on sodium intake or the content of sodium in specific foods that contribute to sodium intake is necessary for monitoring its reduction. This data is not currently available in a systematic or timely fashion and this hampers efforts to evaluate progress made in reducing sodium intake in the American population.

The National Forum for Heart Disease and Stroke Prevention believes that the burden of hypertension cannot be resolved solely by reliance upon federal or state resources. Private-public partnerships have creatively complemented declining government resources to tackle a myriad health issues and must do so in the case of hypertension. We need not look further than the ground gained when political commitment and resources were made available in the fight against tobacco, breast cancer, or HIV/AIDS, to name a few.  

Given the economic burden and health impact associated with hypertension, all stakeholders must wake up, get up, and together take action to make a difference today. The 1 in 3 people living with hypertension and the families and friends of the 1 in 6 people dying of hypertension can wait no longer.