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Cost-effectiveness of secondary screening modalities for hypertension

Y Claire Wang1, Alisa M Koval, Miyabi Nakamura

  • 1Department of Health Policy and Management, Columbia Mailman School of Public Health, Stony Brook University, New York, NY, USA. ycw2102@columbia.edu

Blood Pressure Monitoring
|December 25, 2012
PubMed

Insights

Home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) are cost-effective additions to clinic-based blood pressure (CBP) screening for hypertension diagnosis. These methods improve accuracy and aid treatment decisions.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics

Background:

  • Clinic-based blood pressure (CBP) diagnosis of hypertension can lead to misclassification (masked or white-coat hypertension).
  • Home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) offer improved diagnostic accuracy.

Purpose of the Study:

  • To review the literature on the costs and cost-effectiveness of incorporating HBPM and ABPM into routine blood pressure screening.

Main Methods:

  • Systematic literature review of cost and cost-effectiveness studies.
  • Included studies compared two or more blood pressure monitoring modalities in adults.
  • Excluded were letters, editorials, and studies on specific populations (pregnant, children, diabetes).

Main Results:

  • Fourteen studies were included, analyzing cost outcomes.
  • Ambulatory blood pressure monitoring (ABPM) was cost-saving for diagnostic confirmation after elevated CBP in six studies.
  • Adding home blood pressure monitoring (HBPM) to elevated CBP was cost-effective in three of four studies.

Conclusions:

  • Evidence supports the cost-effectiveness of using HBPM or ABPM after initial CBP diagnosis.
  • Further research should explore implementation, long-term economic value, and utility in identifying masked hypertension.
Abstract

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