Mortality from heart disease declined in the US between 1980 and 2010 due to the decrease in cigarette smoking, more effective treatment of high blood pressure and high cholesterol, and better cardiology interventions for heart attacks. But heart disease is on the rise again. At highest risk are Black and Hispanic people, and those in poverty or with lower rates of education, regardless of race.

The best approach to cardiovascular disease is prevention, which is not costly, since effective blood pressure and cholesterol medicines are mostly generic. However, less than half (42%) of adults who have hypertension are aware of this, and just as many of those with known hypertension have blood pressure that is not currently under good control.

Individuals can lower their cardiovascular risk by following the American Heart Association’s Essential 8: exercise, healthy diet, tobacco cessation, adequate sleep, and control of weight, blood pressure, cholesterol and blood sugar.

Employers can take the following steps to help decrease the burden of cardiovascular disease among their employees and plan members:

1. Discourage smoking by having a smoke-free campus, and offer generous smoking cessation benefits. Two-thirds of smokers (68%) want to quit, but each year only 10% are successful.
2. Encourage healthy eating by offering healthy food choices around the workplace.
3. Encourage exercise by making it easy, through on-site gyms, walking trails, and company teams and clubs. Some companies offer lifestyle spending accounts that can pay for gym memberships and fitness equipment.
4. Include generic blood pressure and cholesterol medicines on preventive medicine lists. Studies have shown greater adherence and lower rates of complications when preventive drugs are not subject to cost sharing.
5. Hold health plans accountable by requiring reporting on blood pressure control and medication adherence as part of periodic quality reporting.

Employer actions to prevent cardiovascular disease can lead to a healthier workforce, longer and better lives for plan members, and lower plan costs.