title: The benefits of treating mild to moderate hypertension. A quantitative estimation of the life expectancy gains from pharmacological reduction of blood pressure.
abstract: A quantitative assessment of the benefits of pharmacological treatment of mild to moderate hypertension (diastolic blood pressure 90-114 mmHg) in patients aged 30-60 years was performed, based on the pooled results of nine major clinical trials. The benefits were expressed as added "quality-adjusted life-years" (QALYs), using life-table methods and utility valuations of health states. The expected gains in QALYs were found to be quite small, ranging from 2.3-11.4 months in males, and 1.4-7.6 months in females. Previous attempts to estimate the nature and magnitude of the benefits of antihypertensive therapy have all been based on extrapolations from epidemiological data, instead of on the actual achieved reductions in mortality and morbidity demonstrated in clinical trials. The former method considerably overestimates the potential direct benefits from drug treatment of mild to moderate hypertension.
authors.affiliation: Department of Community Health, Wellington School of Medicine, New Zealand.
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
authors.forename: L A
authors.initials: LA
authors.lastname: Malcolm
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012680:Sensitivity and Specificity; D012737:Sex Factors
chemical_list: D000959:Antihypertensive Agents