Most Americans with the biggest risks for heart disease are not doing enough to control these risks, and the fragmented U.S. healthcare system is partly to blame, federal health officials said on Tuesday.

Two-thirds of adults with High cholesterol and half with high blood pressure are not being treated effectively, the Centers for Disease Control and Prevention said.

While people without health insurance are the least likely to have blood pressure or cholesterol under control, even those with good health insurance are not doing everything they can, the CDC report found.

“Although we’re making some progress, the United States is failing to prevent the leading cause of death - cardiovascular disease - despite the existence of low-cost, highly effective treatments,” said CDC director Dr. Thomas Frieden.

He said 100 million adults - nearly half the U.S. adult population - have either high blood pressure or unhealthy cholesterol levels.

“In fact, more than 80 percent of people who have out-of-control blood pressure or out-of-control cholesterol do have public or private health insurance,” Frieden told reporters in a telephone briefing.

Heart disease is the No. 1 killer of people in most developed countries. Diet and exercise can prevent heart disease and dozens of drugs are on the market to control the two most common causes - high blood pressure and unhealthy cholesterol levels.

But the CDC report, based on the most recent available survey data, finds that one-third of adults have high blood pressure, a third of them do not get treated for it and half do not have it fully under control.

The figures are worse for unhealthy cholesterol levels. A third of U.S. adults have poor cholesterol readings, half of them are not treated for it and two-thirds do not have their cholesterol fully controlled.

The CDC said a more comprehensive approach is needed “that involves policy and system changes” that help more people get healthcare and to ensure that doctors, nurses and pharmacists work with each other and with patients.

Frieden praised initiatives like Wal-Mart Stores Inc’s announcement last month that it would promote and cut prices on healthier food at its stores.

The CDC said the healthcare reform law now under fire in Congress can help, by requiring health insurers to fully pay for blood pressure and cholesterol screenings and by encouraging the use of electronic medical records.

On Monday, a federal judge in Florida said the law was unconstitutional. The U.S. Supreme Court is likely to have to decide on the fate of the law.

Republicans say they want to repeal and replace it, while most Democrats say it would be more effective to improve existing provisions.

Last month, the American Heart Association projected that the costs of heart disease in the United States would triple between now and 2030, to more than $800 billion a year.

It said treating high blood pressure would be the most expensive part of the cost, rising to $389 billion by 2030.

(Editing by Mohammad Zargham)

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By Maggie Fox, Health and Science Editor

WASHINGTON