Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

Abstract

Background: Hypertension is one of major modifiable risk factors contributing for development of ischemic heart disease, diabetes, kidney disease, cerebrovascular disease and peripheral arterial disease. Silent nature of the disease, delayed presentation of patients to health system after development of significant cardiovascular events and poor access to comprehensive health care are major challenge of hypertension control. Early screening, detection and treatment of hypertension is effective for control of the disease progression. However, there is no robust evidence on whether screening general population for hypertension is cost-effective or not. Therefore, this review was conducted t o generate evidence on cost effectiveness of population-based hypertension screening for asymptomatic individuals as early detection strategy for the primary prevention of cardiovascular diseases. Methods: PubMed/Medline , Scopus, Web of sciences and Google Scholar were searched from January 2000 to 11 December 2019. Two investigators independently selected and reviewed fair and good-quality pharmacoeconomic studies for the cost-effectiveness of asymptomatic screening for hypertension in the community. Quality of selected literatures are evaluated by authors based on comprehensive tool developed for critical appraisal of pharmacoeconomic studies. Results: Eleven included Pharmacoeconomic studies reported favorable results for screening asymptomatic adults for hypertension. Most of studies agreed on cost-effectiveness of screening adults aged 40 years and older. Screening of general adult population for hypertension is not-cost effective. Conclusion: Screening population 40 years and older with or without additional risk factors is cost-effective in reducing hypertension and associated cardiovascular disease morbidity and mortality in developed and developing countries.