Cost-Effectiveness of Masked Hypertension Screening and Treatment in US Adults With Suspected Masked Hypertension: A Simulation Study

Green, Matthew B; Shimbo, Daichi; Schwartz, Joseph; Bress, Adam P.; King, Jordan B.; Muntner, Paul; Sheppard, James P; McManus, Richard J; Kohli-Lynch, Ciaran; Zhang, Yiyi; Shea, Steven; Moran, Andrew E.; Bellows, Brandon K.

doi:10.1093/ajh/hpac071

Cited by 2 publications

(29 citation statements)

References 46 publications

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“…6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30][31] Most studies (13 [81%]) adequately described costs and outcomes, acknowledged limitations, and addressed concerns regarding the accuracy of the measurements. 6,[13][14][15][16]20,21,23,24,[26][27][28]30 Similarly, 12 studies (75%) provided sufficient explanations about how costs and outcomes were measured. 6,13,15,16,20,21,23,24,[26][27][28]30 Differential timing was taken into account in all of the studies.…”

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

“…6,13,15,16,20,21,23,24,[26][27][28]30 Differential timing was taken into account in all of the studies. 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30][31] An incremental analysis of costs and outcomes was conducted in 15 studies (94%). 6,[13][14][15]20,21,[23][24][25][26][27][28][29][30][31] A sensitivity analysis was conducted in 15 studies (94%).…”

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

“…Among the 16 studies, 7 utilized CEA, 6,14,16,20,21,25,29 6 used CUA, 13,23,[26][27][28]30 and 3 utilized both CUA and CEA. 15,24,31 A societal perspective was only reported in 2 studies, 16,31 and the rest were conducted using a health care system perspective.…”

Section: Economic Analysismentioning

confidence: 99%

“…15,24,31 A societal perspective was only reported in 2 studies, 16,31 and the rest were conducted using a health care system perspective. 6,[13][14][15]20,21,[23][24][25][26][27][28][29][30] The types of costs reported in each article were different, with 3 studies reporting direct medical costs only, 14,28,31 1 reporting only program costs, 20 and 12 reporting both 6,13,15,16,21,[23][24][25][26][27]29,30 (Table 2).…”

Section: Economic Analysismentioning

confidence: 99%

“…The health outcome measures differed across studies and included cost per QALY in 8 studies, 13,15,23,24,26,27,30,31 cost per life-year saved in 3 studies, 15,16,25 cost per 1-mm Hg reduction in BP in 7 studies, 6,14,20,21,24,25,29 cost per improved BP control in 3 studies, 14,20,25 and cost per qualityadjusted days (QADs) in 1 study. 28 In 9 studies (4 of which were conducted in the UK, 13,23,26,30 2 in the US, 27,28 and the rest in Russia, 24 Australia, 15 and Singapore 31 ), a willingness to pay threshold (WTP) to determine whether an intervention was cost-effective was mentioned. A sensitivity analysis was conducted in 15 studies (94%) 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30] (Table 3).…”

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

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Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Hayek,

Giannouchos,

Lawley

et al. 2023

JAMA Netw Open

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ImportanceBlood pressure monitoring is critical to the timely diagnosis and treatment of hypertension. At-home self-monitoring techniques are highly effective in managing high blood pressure; however, evidence regarding the cost-effectiveness of at-home self-monitoring compared with traditional monitoring in clinical settings remains unclear.ObjectiveTo identify and synthesize published research examining the cost-effectiveness of at-home blood pressure self-monitoring relative to monitoring in a clinical setting among patients with hypertension.Evidence ReviewA systematic literature search of 5 databases (PubMed, MEDLINE, Embase, EconLit, and CINAHL) followed by a backward citation search was conducted in September 2022. Full-text, peer-reviewed articles in English including patients with high blood pressure (systolic blood pressure ≥130 mm Hg and diastolic blood pressure ≥80 mm Hg) at baseline were included. Data from studies comparing at-home self-monitoring with clinical-setting monitoring alternatives were extracted, and the outcomes of interest included incremental cost-effectiveness and cost-utility ratios. Non–peer-reviewed studies or studies with pregnant women and children were excluded. To ensure accuracy and reliability, 2 authors independently evaluated all articles for eligibility and extracted relevant data from the selected articles.FindingsOf 1607 articles identified from 5 databases, 16 studies met the inclusion criteria. Most studies were conducted in the US (6 [40%]) and in the UK (6 [40%]), and almost all studies (14 [90%]) used a health care insurance system perspective to determine costs. Nearly half the studies used quality-adjusted life-years gained and cost per 1–mm Hg reduction in blood pressure as outcomes. Overall, at-home blood pressure monitoring (HBPM) was found to be more cost-effective than monitoring in a clinical setting, particularly over a minimum 10-year time horizon. Among studies comparing HBPM alone vs 24-hour ambulatory blood pressure monitoring (ABPM) or HBPM combined with additional support or team-based care, the latter were found to be more cost-effective.Conclusions and RelevanceIn this systematic review, at-home blood pressure self-monitoring, particularly using automatic 24-hour continuous blood pressure measurements or combined with additional support or team-based care, demonstrated the potential to be cost-effective long-term compared with care in the physical clinical setting and could thus be prioritized for patients with hypertension from a cost-effectiveness standpoint.

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Section: Study Quality Assessment Criteriamentioning

confidence: 99%

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

Section: Economic Analysismentioning

confidence: 99%

Section: Economic Analysismentioning

confidence: 99%

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

See 3 more Smart Citations

Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Hayek,

Giannouchos,

Lawley

et al. 2023

JAMA Netw Open

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Diversity of hypertension in obesity

2023

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Induced hypertension (HTN) is one of the HTN types, the pathogenetic mechanisms of which are well studied: its main cause lies in the dysfunction of visceral adipose tissue, which leads to renin-angiotensin-aldosterone system activation, imbalance of the sympathetic and parasympathetic systems, renal involvement, and then to vascular endothelium dysfunction and, in fact, to an increase in blood pressure and HTN consolidation. However, within this HTN form, some mechanisms can be distinguished that, in obesity, play a special role. This review describes such additional mechanisms as chronic inflammation, excessive salt intake, dysbiosis, environmental factors. Understanding these HTN features in obesity has essential for achieving target blood pressure levels. In addition, the review pays special attention to such HTN forms in obesity as masked and nocturnal, the timely diagnosis of which is extremely important for the timely initiation of therapy and improving the prognosis.

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Cost-Effectiveness of Masked Hypertension Screening and Treatment in US Adults With Suspected Masked Hypertension: A Simulation Study

Cited by 2 publications

References 46 publications

Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Diversity of hypertension in obesity

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