Cardiovascular disease costs associated with uncontrolled hypertension

This research evaluated the effect of inadequate blood pressure (BP) control on selected cardiovascular (CV) disease outcomes and costs for American patients with hypertension. The results of a hypertension outcomes trial, which provided incidence rates for CV disease morbidity and mortality at distinct systolic/diastolic BP ranges, were integrated with U.S. hypertension statistics from the Third National Health and Nutrition Examination Survey and cost estimates for stroke, congestive heart failure, and myocardial infarction. A model was developed to estimate the number of cases and costs of myocardial infarction, stroke, and congestive heart failure for patients achieving BP control versus those not achieving control. For the U.S. population with hypertension, inadequate BP control was estimated to result in 39,702 CV events, 8,374 CV disease deaths, and $964 million in direct medical expenditures. Within the medicated population with CV disease, the incremental costs of failure to attain BP goals reached approximately $467 million. These results reflect the importance of adequate BP control--in particular, systolic BP control--in reducing cardiovascular morbidity, mortality, and overall health care expenditures among patients with hypertension.