Document Detail


Effectiveness and cost-effectiveness of blood pressure screening in adolescents in the United States.
MedLine Citation:
PMID:  20850759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents in the United States: no intervention, "screen-and-treat," and population-wide strategies to lower the entire BP distribution.
STUDY DESIGN: We used a simulation model to combine several data sources to project the lifetime costs and cardiovascular outcomes for a cohort of 15-year-old U.S. adolescents under different BP approaches and conducted cost-effectiveness analysis. We obtained BP distributions from the National Health and Nutrition Examination Survey 1999-2004 and used childhood-to-adult longitudinal correlation analyses to simulate the tracking of BP. We then used the coronary heart disease policy model to estimate lifetime coronary heart disease events, costs, and quality-adjusted life years (QALY).
RESULTS: Among screen-and-treat strategies, finding and treating the adolescents at highest risk (eg, left ventricular hypertrophy) was most cost-effective ($18000/QALY [boys] and $47000/QALY [girls]). However, all screen-and-treat strategies were dominated by population-wide strategies such as salt reduction (cost-saving [boys] and $650/QALY [girls]) and increasing physical education ($11000/QALY [boys] and $35000/QALY [girls]).
CONCLUSIONS: Routine adolescents BP screening is moderately effective, but population-based BP interventions with broader reach could potentially be less costly and more effective for early cardiovascular disease prevention and should be implemented in parallel.
Authors:
Y Claire Wang; Angela M Cheung; Kirsten Bibbins-Domingo; Lisa A Prosser; Nancy R Cook; Lee Goldman; Matthew W Gillman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-09-17
Journal Detail:
Title:  The Journal of pediatrics     Volume:  158     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-17     Completed Date:  2011-02-24     Revised Date:  2014-05-21    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  257-64.e1-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antihypertensive Agents / adverse effects,  therapeutic use
Blood Pressure Determination
Cohort Studies
Coronary Disease / economics,  prevention & control*
Cost Savings*
Cost-Benefit Analysis
Female
Humans
Hypertension / drug therapy,  economics*,  epidemiology*
Male
Markov Chains
Mass Screening / economics*,  methods
Program Evaluation
Quality-Adjusted Life Years
Risk Assessment
United States
Grant Support
ID/Acronym/Agency:
K24 HL68041/HL/NHLBI NIH HHS; P30 HL101312/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
J Pediatr. 2011 Feb;158(2):181-4   [PMID:  21035817 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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