Report of the Task Force on the Availability of Cardiovascular Drugs to the Medically Indigent.

Abstract

It is more prevalent in blacks than in whites.' * It is the major risk factor for strokes and contrib- utes significantly to heart attacks.It is the major cause of end stage renal disease in blacks.* Medications account for an estimated 20% of the national cost of hypertension, in contrast to other cardiovascular diseases, for which these costs rep- resent a lower fraction of the total (Figure 1).End Stage Renal Disease * It is a major public health problem that is fatal without dialysis or kidney transplantation.* Its most frequent causes are hypertension and diabetes.* Blacks are disproportionately affected: although they represent 12.3% of the US population, they com- prise 28.3% of end stage renal disease patients.2* Adequate treatment of hypertension has been shown to slow the rate of decline in kidney function in patients who already have damaged kidneys.* Medicare End Stage Renal Disease programs fund much of the cost of dialysis and kidney transplantation.In 1988 Medicare's contribution to that cost was 67%, representing $3.7 billion.Stroke * 500,000 Americans are afflicted each year.' * 2,980,000 Americans have had strokes.* It is estimated that in 1992 stroke will result in $2.6 billion in lost productivity.* It is more prevalent in poor people than in the affluent (National Center for Health Statistics, personal communication [unpublished data from Health Interview Studies], September 1990) * It is more prevalent in blacks than in whites.' * Stroke accounts for one half of all patients hospi- talized for acute neurological diseases.