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Comparative Cost-Effectiveness of Hypertension Treatment in Non-Hispanic Blacks and Whites According to 2014

Eshan Vasudeva1, Nathalie Moise2, Chen Huang3

  • 1College of Physicians and Surgeons, Columbia University, New York, USA;

American Journal of Hypertension
|May 14, 2016
PubMed

Insights

Implementing 2014 US hypertension guidelines is cost-effective for both Black and White adults. However, the guidelines extend cost-effectiveness to a larger proportion of Black patients, particularly younger individuals with stage 1 hypertension.

Area of Science:

  • Public Health
  • Health Economics
  • Cardiovascular Disease Prevention

Background:

  • Hypertension treatment guidelines aim to reduce cardiovascular disease (CVD) events.
  • Cost-effectiveness of these guidelines may vary across different demographic groups.

Purpose of the Study:

  • To compare the cost-effectiveness of 2014 US hypertension treatment guidelines between non-Hispanic Black and non-Hispanic White adults.
  • To identify specific subgroups where guideline implementation is most cost-effective.

Main Methods:

  • A cardiovascular disease (CVD) policy model simulated CVD events, quality-adjusted life years (QALYs), and treatment costs in adults aged 35-74 with untreated hypertension.
  • Data on CVD incidence, mortality, and risk factors were sourced from cohort studies, registries, vital statistics, and national surveys.
  • Cost-effectiveness was determined using incremental cost-effectiveness ratios (ICERs), with <$50,000/QALY gained considered cost-effective.

Main Results:

  • Overall 2014 guideline implementation was cost-saving compared to no treatment for both non-Hispanic Black and White populations.
  • Treating 0.7 million hypertensive Black adults could prevent ~8,000 CVD events annually; treating 3.4 million White adults could prevent ~35,000 events.
  • For stage 1 hypertension without diabetes or CKD, cost-effectiveness extended to younger Black males and females (ages 35-44) but not their White counterparts.

Conclusions:

  • Implementing 2014 US hypertension guidelines is cost-effective for both non-Hispanic Black and White populations.
  • The cost-effectiveness of these hypertension guidelines extends to a larger proportion of non-Hispanic Black patients compared to non-Hispanic White patients.
Abstract

Keywords:
blood pressurecost-effectivenesshypertensionrace.

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