title: Study of policies on insured lives with elevated blood pressure known at time of issue.
abstract: BACKGROUND
  The mortality results of policies on insured lives with elevated blood pressure have been the subject of several studies since the early 20th century. This study, which began with issues of 1989, utilizes data from the Impairment Study Capture System (ISCS). Data are also compiled for impairments other than elevated blood pressure in the ISCS for the same study period. A comparison of these 2 sets of data shows the relative severity of elevated blood pressure compared to all other impairments combined. The determination of elevated blood pressure was made on the basis of risk classification due to lack of specific blood pressure readings.
  
  
  METHODS
  Mortality results are actual to expected ratios based on the SOA 1990-95 Select Basic Table. The companies participating in this study have completed 3 steps: (1) agreement to have individual reports to the MIB included in the ISCS file; (2) submission of additional policy information, not on the MIB report; and (3) update of in-force status annually. Reports do not include personal identifying information.
  
  
  RESULTS
  Based on the limited amount of data contributed by relatively few companies, there has been considerable improvement since earlier studies in mortality among insureds with elevated blood pressure. Some possible reasons for this include: (1) fewer smokers--there were fewer smokers in the population and hence applying for insurance during the period covered by this study as compared to earlier studies; (2) improved treatment, patient awareness and adherence to regimen--a wider variety of medications and current treatment practices compared to treatment in the 1970s and early 1980s may have influenced results. Compared to prior studies, it is likely that more insureds with elevated blood pressure first noted on the insurance examination subsequently have received treatment. In addition, those with elevated blood pressure have become more aware of the importance of adhering to their medication regimen and improving other adverse risk factors; (3) improvement in the treatment of related medical conditions.
  
  
  CONCLUSIONS
  The results of this study must be interpreted with caution. The volume of data is not substantial, and the results may not be representative of non-contributing companies. Going forward, it is hoped that more companies will agree to participate such that future studies will produce data and results of greater utility.
authors.forename: Harry
authors.initials: H
authors.lastname: Woodman
authors.forename: Jess
authors.initials: J
authors.lastname: Mast
authors.forename: Anthony
authors.initials: A
authors.lastname: Milano
authors.forename: Douglas
authors.initials: D
authors.lastname: Ingle
authors.forename: Richard
authors.initials: R
authors.lastname: Bergstrom
authors.forename: Anna
authors.initials: A
authors.lastname: Hart
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Hoffman
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D007352:Insurance, Life / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D014481:United States / Q000453:epidemiology