Economic factors in the initiation of antihypertensive therapy.
Optimal management of hypertension involves finding a balance among its benefits, risks and costs.  Cost-effectiveness analysis helps to clarify not only the trade-offs between the costs and benefits of treatment, but also the trade-offs between the risks and benefits, and the costs and quality of therapy.  Existing analyses of hypertension treatment suggest a consistent set of strategies by which cost-effectiveness may be improved.  These include strategies to increase the effectiveness of therapy, such as excluding false-positive diagnoses of hypertension, and according higher priority to treating patients with sustained elevations of diastolic blood pressure above 100mm Hg.  A complementary set of strategies involve reducing the costs of therapy by prescribing lower-cost first-step regimens, making use of the minimum effective dose for particular medicines and attempting step-down therapy for suitable patients.  Consideration of economic factors in initiating hypertension treatment is consistent with sound clinical practice.
Kawachi
I
I
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000191:economics*; D001794:Blood Pressure; D003363:Cost Control; D003362:Cost-Benefit Analysis; D006801:Humans; D006973:Hypertension / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life