Related Experiment Videos
Ambulatory blood pressure monitoring can improve cost-effective management of hypertension
1Department of Medicine, Englewood Hospital and Medical Center, New Jersey 07631.
Insights
Ambulatory blood pressure monitoring (ABPM) can identify patients with hypertension who may not need immediate drug treatment. This approach could reduce costs and the number of individuals requiring medication over time.
Area of Science:
- Cardiology
- Health Economics
- Preventive Medicine
Background:
- Arterial hypertension detection and treatment are effective, yet costs are rising.
- Increasing numbers of patients with minimally elevated pressure contribute to higher treatment expenditures.
- Current monitoring methods like clinic visits are less accurate predictors of outcomes than average daily pressure.
Purpose of the Study:
- To evaluate the role of ambulatory blood pressure monitoring (ABPM) in managing hypertension.
- To develop forecasting models for hypertension management strategies.
- To assess the potential cost-effectiveness of using ABPM.
Main Methods:
- Utilizing noninvasive ambulatory blood pressure monitoring (ABPM) for secondary screening.
- Analyzing average daily pressure as a predictor of outcome and morbidity.
- Developing and comparing hypertension management strategies using forecasting models.
Main Results:
- ABPM identified 20% to 60% of initially labeled hypertensive patients as having normal average daily pressures.
- Preliminary estimates suggest ABPM could reduce the number of patients needing drug treatment over six years.
- Potential for reduced cumulative and yearly costs associated with hypertension management.
Conclusions:
- ABPM offers a more accurate assessment of hypertension than intermittent monitoring.
- Forecasting models incorporating ABPM may lead to significant cost savings and fewer patients on medication.
- Further testing of ABPM-based forecasting models in healthcare systems is warranted to confirm cost-effectiveness.
Abstract:
Detection and treatment of arterial hypertension is effective, as shown by clinical trials and downward trends in cardiovascular disease. This process causes expenditures that progressively have increased because of inclusion of more patients with minimally elevated pressure who incur a higher cost of treatment. Average daily pressure is a more accurate predictor of outcome and morbidity than initial screening or occasional clinic monitoring of pressure. Noninvasive ambulatory blood pressure monitoring (ABPM), as a secondary screening, reveals that 20% to 60% of those initially labeled as hypertensive have average daily pressures low enough to delay the initiation of drug therapy. These observations permit the development of forecasting models comparing strategies for management of hypertension. Preliminary estimates show that use of ABPM might reduce the number of patients requiring drug treatment over a 6 year period, with reduced cumulative and yearly costs for this interval. Forecasting models using ABPM now should be tested in comprehensive health care systems to determine their effect on overall cost-effectiveness in the management of hypertension.