Document Detail


Economic benefits of treating high-risk hypertension with angiotensin II receptor antagonists (blockers).
MedLine Citation:
PMID:  18345711     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension is one of the leading risk factors for cardiovascular disease and represents a major health and economic burden. Most patients with high- or very high-risk hypertension have multiple cardiovascular risk factors with or without accompanying subclinical organ damage or established cardiovascular or renal disease. Patients with severe hypertension or with moderate hypertension and one to two additional risk factors have absolute 10-year risks of cardiovascular disease of 21-30% and 15-20%, respectively. Current European treatment guidelines recommend that antihypertensive therapy be initiated rapidly and aggressively in patients with high-risk hypertension. Most patients require two or more antihypertensive agents to achieve the strict blood pressure target of <130/80 mmHg. This article reviews the existing cost-effectiveness data on the use of angiotensin II receptor antagonists (blockers) [ARBs] in patients with high-risk hypertension. Aggressive ARB treatment of patients in the early (microalbuminuric) stages of diabetic nephropathy has a significant renoprotective effect, delaying the onset of overt (proteinuric) nephropathy. By slowing the progression of these patients to end-stage renal disease, substantial cost savings can be made. There is a paucity of cost-effectiveness data regarding the use of fixed-dose ARB plus thiazide diuretic combination therapies. Longitudinal cost-benefit studies of this attractive and efficacious first-line treatment option are needed.
Authors:
Antonio Coca
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Clinical drug investigation     Volume:  28     ISSN:  1173-2563     ISO Abbreviation:  Clin Drug Investig     Publication Date:  2008  
Date Detail:
Created Date:  2008-03-18     Completed Date:  2008-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504817     Medline TA:  Clin Drug Investig     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  211-20     Citation Subset:  IM    
Affiliation:
Hypertension Unit, Department of Internal Medicine, Institute of Medicine and Dermatology, Hospital Clínico, University of Barcelona, Barcelona, Spain. acoca@clinic.ub.es
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / economics,  therapeutic use*
Blood Pressure / drug effects
Cost-Benefit Analysis
Humans
Hypertension / drug therapy*,  economics,  physiopathology
Outcome Assessment (Health Care) / economics,  statistics & numerical data
Quality-Adjusted Life Years
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers

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