Implementation of treatment according to ACC/AHA 2017 guidelines is cost-effective for high-risk
WEDNESDAY, Nov. 13, 2019 (HealthDay News) — Intensive blood pressure control results in an increase in life expectancy, and new hypertension guidelines may be cost-effective only for certain patients, according to two studies presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.
Muthiah Vaduganathan, M.D., M.P.H., from Harvard Medical School and Brigham and Women’s Hospital in Boston, and colleagues calculated actuarial estimates of residual survival among 9,361 U.S. adults aged ≥50 years at high cardiovascular risk enrolled in the Systolic Blood Pressure Intervention Trial, which was terminated early for benefit. The researchers found that for intensive versus standard blood pressure control, mean survival benefits ranged from 0.5 to three years. The difference in estimated residual survival was 2.9 years at age 50 (95 percent CI, 0.9 to 5.0 years; P = 0.008), 1.1 year at age 65 (95 percent CI, 0.1 to 2.1 years; P = 0.029), and 0.8 years at age 80 (95 percent CI, 0.01 to 1.6 years; P = 0.044).
Joanne M. Penko, M.P.H., from the University of California in San Francisco, and colleagues compared the cost-effectiveness of incrementally implementing treatment according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines with the 2003 Joint National Committee on Hypertension guidelines in currently untreated adults (aged 35 to 84 years) with hypertension. The researchers found that applying the 2017 ACC/AHA guidelines to only cardiovascular disease patients would result in an incremental cost-effectiveness ratio of about $25,000 per quality-adjusted life year (QALY) in the oldest men to $900,000/QALY in the youngest women.
“The study’s findings suggest an incremental approach to implementing the 2017 ACC/AHA hypertension guidelines, first focusing limited resources on treating the oldest, highest-risk adults to intensive blood pressure goals,” Penko said in a statement.
Several authors from the Vaduganathan study disclosed financial ties to the pharmaceutical industry.
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