Abstract
For more than 30 years, the benefits of antihypertensive therapy have been assessed in randomized trials that monitor cardiovascular events. Even greater benefits can result if prevention of (1) congestive heart failure, (2) left ventricular hypertrophy, and (3) progression to more severe hypertension is taken into consideration. However, quantifying the benefits in order to calculate the cost-effectiveness of treatment is not easy. Taking absolute risk and benefit as the only guide to treatment decisions may result in limiting therapy only to elderly hypertensive patients and hypertensive patients with complications. Furthermore, randomized trials, of which the duration is necessarily short, are likely to underestimate treatment benefits. An alternative to such an approach is the actuarial approach: treatment benefits are calculated from the actuarial data showing the reduction in life expectancy associated with any given blood pressure increase. The cost of antihypertensive therapy per year of life gained calculated in this way is much lower than the cost calculated from randomized trials. In an uncertain area such as that of cost-effectiveness evaluation, it is important that both approaches are token into consideration by physicians, patients, politicians, and officers of national health systems.
| Original language | English |
|---|---|
| Pages (from-to) | 3-8 |
| Number of pages | 6 |
| Journal | The American Journal of Cardiology |
| Volume | 79 |
| Issue number | 10 A |
| DOIs | |
| Publication status | Published - May 22 1997 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Antihypertensive therapy : How to evaluate the benefits. / Zanchetti, Alberto.
In: The American Journal of Cardiology, Vol. 79, No. 10 A, 22.05.1997, p. 3-8.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antihypertensive therapy
T2 - How to evaluate the benefits
AU - Zanchetti, Alberto
PY - 1997/5/22
Y1 - 1997/5/22
N2 - For more than 30 years, the benefits of antihypertensive therapy have been assessed in randomized trials that monitor cardiovascular events. Even greater benefits can result if prevention of (1) congestive heart failure, (2) left ventricular hypertrophy, and (3) progression to more severe hypertension is taken into consideration. However, quantifying the benefits in order to calculate the cost-effectiveness of treatment is not easy. Taking absolute risk and benefit as the only guide to treatment decisions may result in limiting therapy only to elderly hypertensive patients and hypertensive patients with complications. Furthermore, randomized trials, of which the duration is necessarily short, are likely to underestimate treatment benefits. An alternative to such an approach is the actuarial approach: treatment benefits are calculated from the actuarial data showing the reduction in life expectancy associated with any given blood pressure increase. The cost of antihypertensive therapy per year of life gained calculated in this way is much lower than the cost calculated from randomized trials. In an uncertain area such as that of cost-effectiveness evaluation, it is important that both approaches are token into consideration by physicians, patients, politicians, and officers of national health systems.
AB - For more than 30 years, the benefits of antihypertensive therapy have been assessed in randomized trials that monitor cardiovascular events. Even greater benefits can result if prevention of (1) congestive heart failure, (2) left ventricular hypertrophy, and (3) progression to more severe hypertension is taken into consideration. However, quantifying the benefits in order to calculate the cost-effectiveness of treatment is not easy. Taking absolute risk and benefit as the only guide to treatment decisions may result in limiting therapy only to elderly hypertensive patients and hypertensive patients with complications. Furthermore, randomized trials, of which the duration is necessarily short, are likely to underestimate treatment benefits. An alternative to such an approach is the actuarial approach: treatment benefits are calculated from the actuarial data showing the reduction in life expectancy associated with any given blood pressure increase. The cost of antihypertensive therapy per year of life gained calculated in this way is much lower than the cost calculated from randomized trials. In an uncertain area such as that of cost-effectiveness evaluation, it is important that both approaches are token into consideration by physicians, patients, politicians, and officers of national health systems.
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U2 - 10.1016/S0002-9149(97)00264-6
DO - 10.1016/S0002-9149(97)00264-6
M3 - Article
C2 - 9186060
AN - SCOPUS:0030831203
VL - 79
SP - 3
EP - 8
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 10 A
ER -