Americans with hypertension who were enrolled in employee-sponsored health insurance plans spent 18.3 percent more on healthcare in 2016 than they did in 2012, according to an issue brief released March 6 by the Health Care Cost Institute (HCCI).

Prescription drug spending increased by 27.2 percent over that period, even though more low-cost generics were used in 2016. This suggests the brand-name drugs people used became more expensive, either through the utilization of different drugs or price hikes for existing ones.

“Hypertension is one of the most common chronic conditions in the U.S. and a contributor to two leading causes of death: heart attack and stroke,” HCCI president Niall Brennan said in a press release. “It’s vital to understand the underlying drivers of spending and cost growth in this population. While the burden on health is substantial, the already high cost of this care keeps going up.”

Here are other key findings from the report:

• Adults with hypertension spent 3.2 times more in total and 2.2 times more out-of-pocket than adults without hypertension in 2016. The average monetary figures were $14,399 versus $4,495 for total spending and $1,771 versus $791 for out-of-pocket spending.
• Adults with hypertension accounted for 40.8 percent of all healthcare spending despite comprising only 18 percent of the study sample.
• Hypertensive adults used fewer inpatient and professional services in 2016 than they did in 2012, but used slightly more outpatient services and prescription drugs.
• The greatest disparity in annual healthcare spending between hypertensive and non-hypertensive peers existed among 19- to 26-year-olds ($15,812 versus $2,927).
• The costliest group overall was pre-Medicare adults ages 55 to 64, who accounted for more than half of all spending by working adults with hypertension.

Notably, this data was from before the American College of Cardiology and American Heart Association lowered the bar for high blood pressure to 130/80 millimeters of mercury in November 2017. The new threshold will bump the estimation of American adults with hypertension from 32 percent of the population to 46 percent.

And while most of the newly hypertensive Americans will be recommended for lifestyle modifications rather than medications, an additional 4.2 million could be recommended for drug therapy under the updated guideline, according to a study published in January in the Journal of the American College of Cardiology. This could cause the cost of care for hypertensive patients to increase more markedly than previous years.