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ArticlePublication 2023Cost-Effectiveness of Intensive vs. Standard Blood Pressure Control Among Older Patients
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older …
This economic analysis explored the cost-effectiveness of intensive vs standard blood pressure control in older hypertensive patients between 60 and 80 years in China, the US, and the UK. Treatment outcome data from the Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension (STEP trial) and different cardiovascular risk assessment models for a hypothetical cohort of STEP-eligible patients were used. Costs and utilities were obtained from published sources. A Markov model was used to…
Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | North America -
ArticlePublication 2023Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control …
This study estimates the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve blood pressure control in the US. A cost-effectiveness analysis was conducted using a Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION). Outcomes included cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). Costs were based on reimbursement rates, published literature, national…
Mathematical Models | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2022Cost-Effectiveness of Masked Hypertension Screening and Treatment
The study assessed the health and economic outcomes of screening and treating masked hypertension in …
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD). Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM).…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2022Systematic Review of Patient Preferences, Expectations, and Values for Management and Treatment of Hypertension
This analysis summarized the evidence on the preferences, expectations, and values of hypertension management and …
This analysis summarized the evidence on the preferences, expectations, and values of hypertension management and treatment in hypertensive patients. The authors reviewed 24 studies involving 8,701 participants. Despite varying areas of focus, common themes included (1) patients often obtain hypertension information from their physicians and prefer shared patient-centered decision-making, and (2) side effects, cost, and convenience are important factors for patients when selecting a treatment regimen for hypertension.
Preferences/Values | Health Outcomes | Chronic Disease/Risk | Clinical Care -
ArticlePublication 2021Cost-Effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops
The Los Angeles Barbershop Blood Pressure Study (LABBPS) examined the effectiveness and cost of a …
The Los Angeles Barbershop Blood Pressure Study (LABBPS) examined the effectiveness and cost of a one-year pharmacist-led hypertension care intervention in Black-owned barbershops in Los Angeles County, focused on non-Hispanic Black men with uncontrolled hypertension. Using a discrete event simulation, the researchers projected the 10-year health outcomes and health care costs associated with the intervention compared to a control group. The costs and quality-adjusted life-years (QALYs) were calculated from a health care sector perspective, with…
Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2019Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary …
This study compared three methods of blood pressure (BP) measurement for diagnosing hypertension in primary care settings, accounting for the possibility of false-positive (white-coat hypertension) and false-negative (masked hypertension) clinic measurements. Outcomes included quality-adjusted life years (QALYs) and lifetime costs associated with clinic BP measurement, home BP monitoring, and ambulatory blood pressure monitoring (ABPM) under two scenarios: positive and negative initial screening. Data were from published literature, public data sources, and expert input. In the…
Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2018Association of BP Classification Using 2017 Guidelines with Cardiovascular Events Later in Life
This article aimed to assess whether young adults who developed hypertension, defined by the 2017 …
This article aimed to assess whether young adults who developed hypertension, defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) blood pressure (BP) guideline, before age 40 years have higher risk for CVD events compared with those who maintained normal BP. The study enrolled 5115 African American and white participants aged 18 to 30 years from 4 US field centers. Each participant was categorized as having normal BP (n = 2574); elevated BP (n = 445);…
Health Outcomes | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2018Association of Hypertension Guidelines with Cardiovascular Events and Deaths in US Adults
This article aimed to compare the 2017 American College of Cardiology/American Heart Association hypertension guideline …
This article aimed to compare the 2017 American College of Cardiology/American Heart Association hypertension guideline to the 2014 evidence-based hypertension guideline in terms of the proportion of US adults defined as being hypertensive or recommended for antihypertensive treatment and with risk reduction of major cardiovascular disease (CVD) and all-cause mortality. Results indicated that, according to the 2017 hypertension guideline, the prevalence of hypertension (BP level ≥130/80 mm Hg) was 45.4%, representing 105.3 million US adults,…
Health Outcomes | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ReportPublication 2017Clinical Practice Guideline Implementation Strategies: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
This report presents evidence on effective strategies to enhance the adoption of clinical practice guidelines …
This report presents evidence on effective strategies to enhance the adoption of clinical practice guidelines from the published literature. This report was produced as part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity that the National Heart, Lung, and Blood Institute convened in 2008. The authors conducted a systematic review on 4 questions focused on the adoption and effectiveness of 4 interventions: (1) reminders, (2) educational outreach…
Evidence Synthesis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2017Benefit and Harm of Intensive Blood Pressure Treatment: Derivation and Validation of Risk Models Using Data from the Sprint and Accord Trials
Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some …
Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some serious adverse events. The authors sought to create risk calculators to estimate individual patients’ chances of benefit and harm from intensive treatment. They developed statistical models of cardiovascular events and serious adverse events from individual participant data from the Systolic Blood Pressure Intervention Trial (SPRINT) of intensive blood pressure treatment (N = 9,069 with complete covariate data) and validated them…
Probability/Bayes | Health Outcomes | Evidence Synthesis | Chronic Disease/Risk -
ArticlePublication 2017Benefits and Harms of Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older
Recent guidelines recommend a systolic blood pressure (SBP) goal of less than 150 mm Hg …
Recent guidelines recommend a systolic blood pressure (SBP) goal of less than 150 mm Hg for adults aged 60 years or older, but the balance of benefits and harms is unclear in light of newer evidence. The purpose of this study was to systematically review the effects of more versus less intensive BP control in older adults. Authors reviewed 21 randomized, controlled trials comparing BP targets or treatment intensity, and 3 observational studies that assessed…
Health Outcomes | Evidence Synthesis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2017Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control
Based on data from the Systolic Blood Pressure Intervention Trial (SPRINT), the authors of this …
Based on data from the Systolic Blood Pressure Intervention Trial (SPRINT), the authors of this article compared the cost-effectiveness of intensive versus standard control in adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control. A microsimulation model was used to project lifetime costs of treatment and monitoring, cardiovascular disease events and subsequent treatment costs, treatment-related risks of serious adverse events and subsequent costs, and quality-adjusted life-years (QALYs) for the two strategies.…
Health Outcomes | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
GuidelinesPublication 2017Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults
In 2013, the National Heart, Lung, and Blood Institute (NHLBI) Advisory Council recommended that the …
In 2013, the National Heart, Lung, and Blood Institute (NHLBI) Advisory Council recommended that the NHLBI focus specifically on reviewing the highest-quality evidence and partner with other organizations to develop recommendations. Accordingly, the ACC and AHA collaborated with the NHLBI and stakeholder and professional organizations to complete and publish four guidelines in the domain of cardiovascular health, including this guideline. In 2014, the American College of Cardiology (ACC) and American Heart Association (AHA), in partnership…
Health Outcomes | Evidence Synthesis | Test Performance | Chronic Disease/Risk | Health Systems | Health/Medicine | North America | Europe -
ArticlePublication 2017Cost-Effectiveness of Screening for Hypertension and Counseling for Prevention
This article aimed to compare the health and economic impact of 3 services recommended by …
This article aimed to compare the health and economic impact of 3 services recommended by the US Preventive Services Task Force for the primary prevention of cardiovascular disease (CVD): (1) aspirin counseling for the primary prevention of CVD and colorectal cancer, (2) screening and treatment for lipid disorders (usually high cholesterol), and (3) screening and treatment for hypertension. A microsimulation model was used to compare lifetime outcomes from the societal perspective for a US-representative birth…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Clinical Care | Health/Medicine | North America -
ArticlePublication 2017Personalizing the Intensity of Blood Pressure Control, Modeling the Heterogeneity
The Systolic Blood Pressure Intervention Trial (SPRINT) suggests that, on average, hypertensive patients at high …
The Systolic Blood Pressure Intervention Trial (SPRINT) suggests that, on average, hypertensive patients at high cardiovascular risk would have less cardiovascular morbidity and mortality but higher treatment-related adverse events with an intensive blood pressure treatment strategy as compared with a standard blood pressure treatment strategy. Applying these population-level results to individual patients is challenging, as each patient may have different benefits and risks than the average patient in SPRINT. Using patient-level data from SPRINT, the authors developed…
Probability/Bayes | Health Outcomes | Evidence Synthesis | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | North America -
GuidelinesPublication 2017Summary: 2017 Guideline for Management of High Blood Pressure in Adults
This report from the American College of Cardiology/American Heart Association Task Force on Clinical Practice …
This report from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines provides a detailed summary of the 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Sections: Important Statistics Diagnosing Hypertension Measurement of BP Patient Evaluation and History Hypertensive Crises: Urgency vs Emergency Laboratory Tests and Other Diagnostic Procedures Out-of-Office Monitoring of BP Masked and White Coat Hypertension Treating Hypertension Blood Pressure…
Evidence Synthesis | Chronic Disease/Risk | Social Determinants | Health Systems | Health/Medicine | Science/Technology | North America | Europe -
ArticlePublication 2016Cost-Effectiveness of Blood Pressure Treatment Guidelines in Adults 35-74
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of …
In this article the authors used the CVD Policy Model to compare the cost-effectiveness of conservative versus intensive blood pressure treatment guidelines in adult hypertensive patients aged 35 to 74 years. Outcomes included in the study were CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs projected over the years 2016 to 2026. The effectiveness and costs of hypertension were calculated for treatment according to the 2003 Joint National Committee (JNC)-7 or…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2016Cost-Effectiveness of Hypertension Treatment According to 2014 Guidelines
This article compared the cost-effectiveness of hypertension treatment in non-Hispanic blacks and non-Hispanic whites according …
This article compared the cost-effectiveness of hypertension treatment in non-Hispanic blacks and non-Hispanic whites according to 2014 US hypertension treatment guidelines. The cardiovascular disease (CVD) policy model was used to simulate CVD events, quality-adjusted life years (QALYs), and treatment costs in 35- to 74-year-old adults with untreated hypertension. CVD incidence, mortality, and risk factor levels were obtained from cohort studies, hospital registries, vital statistics, and national surveys. The authors assumed a willingness-to-pay for health of…
Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2016Cost-Effectiveness of Intensive Blood Pressure Management
This article aimed to evaluate the cost-effectiveness of intensive blood pressure management compared with standard …
This article aimed to evaluate the cost-effectiveness of intensive blood pressure management compared with standard management among 68-year-old high-risk adults with hypertension but not diabetes. A Markov cohort model was developed to estimate lifetime costs and quality-adjusted life-years (QALYs) discounted at 3% annually. The Systolic Blood Pressure Intervention Trial (SPRINT) was used to estimate treatment effects and adverse event rates. The authors used Centers for Disease Control and Prevention Life Tables to project age- and…
State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2015Cost-Effectiveness of Hypertension Therapy According to 2014 Guidelines
Because many eligible adults with hypertension in the United States remain untreated, the authors of …
Because many eligible adults with hypertension in the United States remain untreated, the authors of this article projected the cost-effectiveness of treating hypertension in U.S. adults according to the 2014 guidelines. The Cardiovascular Disease Policy Model was used to simulate drug-treatment and monitoring costs, costs averted for the treatment of cardiovascular disease, and quality-adjusted life-years (QALYs) gained by treating previously untreated adults between the ages of 35 and 74 years from 2014 through 2024. Cost-effectiveness…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2011Cost-Effectiveness of Blood Pressure Screening in Adolescents in the U.S.
This article compares the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood …
This article compares the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents in the United States. These approaches are (1) no intervention, (2) "screen-and-treat," and (3) population-wide strategies to lower the entire BP distribution. The authors obtained BP distributions from the National Health and Nutrition Examination Survey 1999-2004 and used childhood-to-adult longitudinal correlation analyses to simulate the tracking of BP. They then used the coronary heart disease policy…
Health Outcomes | State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | North America -
ArticlePublication 2008Cost-Effectiveness of First-Step Treatment for Hypertension: ALLHAT Trial
This article aimed to evaluate the cost-effectiveness of first-line treatments (lisinopril, amlodipine, and chlorthalidone) for …
This article aimed to evaluate the cost-effectiveness of first-line treatments (lisinopril, amlodipine, and chlorthalidone) for hypertension. Uncertainty was evaluated using bootstrap resampling. Results indicated that over a patient’s lifetime, chlorthalidone was always least expensive (mean $4,802 less than amlodipine, $3,700 less than lisinopril). Amlodipine provided more life-years (LYs) than chlorthalidone in 84% of bootstrap samples (mean 37 days) at an incremental cost-effectiveness ratio of $48,400 per LY gained. Lisinopril provided fewer LYs than chlorthalidone in…
Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | North America -
ArticlePublication 2005Cost-Effectiveness Analysis of Hypertension Guidelines in South Africa
This article aimed to investigate the cost-effectiveness of different strategies for initiation of drug treatment …
This article aimed to investigate the cost-effectiveness of different strategies for initiation of drug treatment (i.e., guideline-based on blood pressure level or based on absolute cardiovascular disease (CVD) risk) in developing countries. The authors used a Markov CVD model to compare the following 6 strategies: 2 different blood pressure levels (160/95 and 140/90 mm Hg) and 4 different levels of absolute CVD risk over 10 years (40%, 30%, 20%, and 15%)—with one of no treatment.…
State-Transition | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine | Sub-Saharan Africa
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