Author Interviews, Blood Pressure - Hypertension, JAMA, Stanford / 16.09.2016
Intensive Blood Pressure Management Found To Be Cost Effective
MedicalResearch.com Interview with:
Ilana B. Richman, MD
Palo Alto VA Health Care System, Palo Alto, California
Center for Primary Care and Outcomes Research/Center for Health Policy
Department of Medicine
Stanford University School of Medicine
Stanford, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In November of 2015, researchers published results from the Systolic Blood Pressure Intervention Trial (SPRINT). This large, NIH-funded study compared a systolic blood pressure target of 120 mm Hg vs 140 mm Hg among hypertensive, nondiabetic patients at elevated risk for cardiovascular disease. SPRINT reported a 25% reduction in the rate of cardiovascular disease and death among those treated to a lower target. Those treated to a lower target blood pressure, though, experienced certain adverse events more frequently.
Our cost effectiveness analysis asked two questions: given the potential risks and benefits described in SPRINT, does achieving a lower systolic blood pressure result in net benefit over the course of a lifetime? And if it does, how much would it cost, compared to standard treatment? We found that achieving a lower blood pressure target does result in a net benefit, with a gain of about 0.9 years of life (quality adjusted) among those treated to a lower target compared to those treated to a standard target. This gain, though, required some investment. We found that treating to a lower blood pressure target cost $23,777 per quality-adjusted life year gained. Compared to other commonly used interventions here in the US, this would be considered an excellent value.
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