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Cost-Effectiveness of Hypertension Therapy According to 2014 Guidelines

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Title Cost-Effectiveness of Hypertension Therapy According to 2014 Guidelines
Names Moran, Andrew E. (creator)
Odden, Michelle C. (creator)
Thanataveerat, Anusorn (creator)
et al. (creator)
Date Issued 2015-01-29 (iso8601)
Note This is the publisher’s final pdf. The published article is copyrighted by the Massachusetts Medical Society and can be found at: http://www.nejm.org/.
Abstract BACKGROUND: On the basis of the 2014 guidelines for hypertension therapy in the United States,
many eligible adults remain untreated. We projected the cost-effectiveness of treating
hypertension in U.S. adults according to the 2014 guidelines.
METHODS: We used the Cardiovascular Disease Policy Model to simulate drug-treatment and
monitoring costs, costs averted for the treatment of cardiovascular disease, and
quality-adjusted life-years (QALYs) gained by treating previously untreated adults
between the ages of 35 and 74 years from 2014 through 2024. We assessed cost-effectiveness
according to age, hypertension level, and the presence or absence of
chronic kidney disease or diabetes.
RESULTS: The full implementation of the new hypertension guidelines would result in approximately
56,000 fewer cardiovascular events and 13,000 fewer deaths from cardiovascular
causes annually, which would result in overall cost savings. The projections
showed that the treatment of patients with existing cardiovascular disease or
stage 2 hypertension would save lives and costs for men between the ages of 35 and
74 years and for women between the ages of 45 and 74 years. The treatment of men
or women with existing cardiovascular disease or men with stage 2 hypertension
but without cardiovascular disease would remain cost-saving even if strategies to
increase medication adherence doubled treatment costs. The treatment of stage 1
hypertension was cost-effective (defined as <$50,000 per QALY) for all men and for
women between the ages of 45 and 74 years, whereas treating women between the
ages of 35 and 44 years with stage 1 hypertension but without cardiovascular disease
had intermediate or low cost-effectiveness.
CONCLUSIONS: The implementation of the 2014 hypertension guidelines for U.S. adults between the
ages of 35 and 74 years could potentially prevent about 56,000 cardiovascular events
and 13,000 deaths annually, while saving costs. Controlling hypertension in all
patients with cardiovascular disease or stage 2 hypertension could be effective and
cost-saving. (Funded by the National Heart, Lung, and Blood Institute and others.)
Genre Article
Identifier Moran, A. E., Odden, M. C., Thanataveerat, A., Tzong, K. Y., Rasmussen, P. W., Guzman, D., ... & Goldman, L. (2015). Cost-Effectiveness of Hypertension Therapy According to 2014 Guidelines. New England Journal of Medicine, 372(5), 447-455. doi:10.1056/NEJMsa1406751

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