Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis
2019
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 screen-positive scenario, ABPM was the dominant strategy among all age and sex groups. Compared with clinic BP measurement, this strategy was associated with cost-savings ranging from $77 to $5,013 depending on age. In the screen-negative scenario, ABPM was also the dominant strategy in all men and women with cost-savings ranging from $128 to $2,794 depending on age. Sensitivity analyses showed that results were sensitive to test specificity and antihypertensive medication costs.
Source:
Beyhaghi H, Viera AJ. Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults. Hypertension 2019; 73 (1): 121-131. https://doi.org/10.1161/hypertensionaha.118.11715