Medical Care Expenditures for Hypertension, Its Complications, and Its Comorbidities

Hodgson, Thomas A.; Cai, Liming

doi:10.1097/00005650-200106000-00008

Cited by 141 publications

(107 citation statements)

References 33 publications

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“…Some studies have demonstrated an association between comorbidity and healthcare costs 32, 33, 34. In our study, comorbidity was found to be associated with higher pharmaceutical expenditure among people with established ASCVD.…”

Section: Discussionsupporting

confidence: 60%

Association Between Modifiable Risk Factors and Pharmaceutical Expenditures Among Adults With Atherosclerotic Cardiovascular Disease in the United States: 2012–2013 Medical Expenditures Panel Survey

Salami

Ogunmoroti

Spatz

et al. 2017

JAHA

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BackgroundAtherosclerotic cardiovascular disease (ASCVD) causes most deaths in the United States and accounts for the highest healthcare spending. The association between the modifiable risk factors (MRFs) of ASCVD and pharmaceutical expenditures are largely unknown.Methods and ResultsWe examined the association between MRFs and pharmaceutical expenditures among adults with ASCVD using the 2012 and 2013 Medical Expenditure Panel Survey. A 2‐part model was used while accounting for the survey's complex design to obtain nationally representative results. All costs were adjusted to 2013 US dollars using the gross domestic product deflator. The annual total pharmaceutical expenditure among those with ASCVD was $71.6 billion, 33% of which was for medications for cardiovascular disease and 14% medications for diabetes mellitus. The adjusted relationship between MRFs and pharmaceutical expenditures showed significant marginal increase in average annual pharmaceutical expenditure associated with inadequate physical activity ($519 [95% confidence interval (CI), $12–918; P=0.011]), dyslipidemia ($631 [95% CI, $168–1094; P=0.008]), hypertension: ($1078 [95% CI, $697–1460; P<0.001)], and diabetes mellitus ($2006 [95% CI, $1470–2542]). Compared with those with optimal MRFs (0–1), those with average MRFs (2–3) spent an average of $1184 (95% CI, $805–1564; P<0.001) more on medications, and those with poor MRFs (≥4) spent $2823 (95% CI, $2338–3307; P<0.001) more.ConclusionsWorsening MRFs were proportionally associated with higher annual pharmaceutical expenditures among patients with established ASCVD regardless of non‐ASCVD comorbidity. In‐depth studies of the roles played by other factors in this association can help reduce medication‐related expenditures among ASCVD patients.

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Section: Discussionsupporting

confidence: 60%

Association Between Modifiable Risk Factors and Pharmaceutical Expenditures Among Adults With Atherosclerotic Cardiovascular Disease in the United States: 2012–2013 Medical Expenditures Panel Survey

Salami

Ogunmoroti

Spatz

et al. 2017

JAHA

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“…Descriptions of the WHI study and additional details describing this study have been published. 9 The WHI eligibility criteria included: (1) age at entry between 50 to 79; (2) the ability and willingness to provide written informed consent for the pertinent program components; (3) an expectation of being resident in the study recruitment area for at least 3 years following enrolment; and (4) the absence of any exclusion criterion. Exclusion criteria were: (1) presence of medical conditions predictive of a survival time of o3 years; (2) conditions or characteristics inconsistent with study participation and adherence (alcoholism, drug dependency, mental illness and dementia); and (3) active participants in a randomized controlled clinical trial.…”

Section: Study Subjectsmentioning

confidence: 99%

“…11 We also used categorical classifications (hypertensive or normotensive) to assess the odds ratios (OR) for hypertension in the admixed populations. For these assessments, we used the following definitions: (1) In addition, we also performed analyses in which individuals that met either diastolic or systolic definitions were classified as hypertensive and individuals meeting both diastolic and systolic definitions for the normal range were classified as normotensive.…”

Section: Study Subjectsmentioning

confidence: 99%

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Relationship between hypertension and admixture in post-menopausal African American and Hispanic American women

Kosoy

Nassir

et al. 2011

J Hum Hypertens

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To assess the relationship between ethnicity and hypertension using individual admixture and blood pressure measurements, we performed a cross-sectional study of African American and Hispanic American (HA) women enrolled in the Women's Health Initiative. The admixture odds ratio for systolic and diastolic hypertensive risk was determined using linear regression models in which the proportional measurements of European (EUR), sub-Saharan African (AFR) and Amerindian (AMI) admixture was analyzed using ancestry informative markers. In both African-American women (n ¼ 10 147) and HA women (n ¼ 4908) there was a significant positive association between hypertension and African admixture (Po10 À4 ). This relationship was observed for both systolic and diastolic hypertension examined as a continuous or dichotomous trait, and whether age, body mass index, years since menopause and a measurement of socioeconomic status were used as covariates. The odds ratio associated with AFR admixture in a dichotomous model of hypertension was 3.06 (95% confidence interval 2.72-3.45). AMI admixture was associated with lower odds of hypertension and appeared to be more protective, relative to EUR admixture. These data show that African admixture increases the risk for hypertension and provide additional support for evaluating therapeutic efficacy and conducting genetic analyses of hypertension in different ethnic groups.

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“…Por otra parte, si un paciente no cumple con las indicaciones médicas es imposible estimar el efecto del tratamiento, lo que a su vez puede contribuir a prolongar la terapia y perpetuar enfermedades o problemas de salud e incluso conducir a la muerte, con el consecuente costo económico para el estado, tanto en materias relativas a pérdida de productividad y costos asociados a rehabilitación y pensiones de invalidez (por ejemplo, el costo asociado al tratamiento de la hipertensión y sus complicaciones representó 12,6% del gasto total de atención de salud en Estados Unidos de Norteamérica en 1998) 7 .…”

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Psicología de la salud: Una clave para comprender el fenómeno de la adherencia terapéutica

Ortiz

2007

Rev. méd. Chile

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The lack of compliance with treatment is a public health problem that affects the patient ' L a irrupción de nuevas tecnologías y tratamientos farmacológicos han posibilitado contar cada día con mejores y más variadas prescripciones médicas. Esto, a su vez, debiera significar un aumento tanto en la efectividad de los tratamientos, así como también incidir directamente en la calidad de vida de los pacientes. Sin embargo, para que esto ocurra debieran existir al menos dos condiciones: una adecuada prescripción por parte del equipo médico y un correcto cumplimiento de la misma. Debido a que la prescripción médica es un tema que corresponde sólo a competencias de médicos, esta revisión se centrará en la adherencia a los tratamientos médicos, aspecto conductual en el cual la psicología de la salud tiene mucho que aportar.LA IMPORTANCIA DE ESTUDIAR LA ADHERENCIA TERAPÉUTICA Varios son los motivos por los cuales estudiar la adherencia a los tratamientos. En primer lugar, gran parte de las indicaciones terapéuticas no pueden ser supervisadas cotidianamente por una agente externo al paciente y, al contrario, quedan bajo su directa responsabilidad, entonces, es el paciente quien en definitiva decide si cumplir o no. En efecto, las bajas tasas de adherencia comunicadas, parecieran apoyar la idea de que el paciente mayoritariamente no cumple con el tratamiento. Por ejemplo, el National Heart, Lung

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Medical Care Expenditures for Hypertension, Its Complications, and Its Comorbidities

Cited by 141 publications

References 33 publications

Association Between Modifiable Risk Factors and Pharmaceutical Expenditures Among Adults With Atherosclerotic Cardiovascular Disease in the United States: 2012–2013 Medical Expenditures Panel Survey

Association Between Modifiable Risk Factors and Pharmaceutical Expenditures Among Adults With Atherosclerotic Cardiovascular Disease in the United States: 2012–2013 Medical Expenditures Panel Survey

Relationship between hypertension and admixture in post-menopausal African American and Hispanic American women

Psicología de la salud: Una clave para comprender el fenómeno de la adherencia terapéutica

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