[Official recommendations and guidelines for the management and reimbursement of severe hypertension as a chronic disease].
Severe hypertension is a major cardiovascular and cerebrovascular risk factor and places the patient in the category of high cardiovascular risk, independently of any other cardiovascular risk factors. The economic burden of hypertension is high, with severe hypertension the 4th most costly disease (5.5 billion Euros) on the French list of chronic diseases ("Affections de longue durée" or ALD) for which the national health insurance funds reimburse 100% of expenses. The French High Health Authority recently suggested removing hypertension from the ALD list. This recommendation, however, had no scientific rationale but was motivated instead by economic and political factors and may endanger the quality of management of hypertensive patients. The previous ALD criteria for severe hypertension require revision to bring them into line with the recommendations of professional and learned societies. The ALD list should include severe hypertension as well as complicated and treatment-resistant hypertension, with the diagnosis documented by ambulatory or self blood pressure monitoring.
Boivin
Jean-Marc
JM
Université Henri Poincaré et CIC-Inserm de Nancy, Hôpital Jeanne d'Arc, F-54200 Dommartin-les-Toul, France.
Zannad
Faiez
F
D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory / Q000191:economics; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control; D002561:Cerebrovascular Disorders / Q000191:economics / Q000517:prevention & control; D002908:Chronic Disease; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data*; D005245:Fee Schedules / Q000706:statistics & numerical data*; D005602:France; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics*; D008134:Long-Term Care / Q000191:economics; D009313:National Health Programs / Q000191:economics*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics; D012051:Reimbursement Mechanisms / Q000191:economics*; D012307:Risk Factors
D000959:Antihypertensive Agents