title: Yearly hypertension screening in women with a history of pre-eclampsia: a cost-effectiveness analysis.
abstract: BACKGROUND
  Women with a history of preeclampsia are at increased risk for future hypertension and cardiovascular disease (CVD); until now it is not clear whether preventive measures are needed.
  
  
  METHODS
  A decision-analytic Markov model was constructed to evaluate healthcare costs and effects of screening and treatment (100 % compliance) for hypertension post preeclampsia based on the available literature. Cardiovascular events and CVD mortality were defined as health states. Outcomes were measured in absolute costs, events, life-years and quality-adjusted life-years (QALYs). Sensitivity and threshold analyses were performed to address uncertainty.
  
  
  RESULTS
  Over a 20-year time horizon, events occurred in 7.2 % of the population after screening, and in 8.5 % of the population without screening. QALYs increased from 16.37 (no screening strategy) to 16.40 (screening strategy), an increment of 0.03 (95 % CI 0.01;0.05) QALYs. Total expected costs were € 8016 in the screening strategy, and € 9087 in the none screening strategy (expected saving of € 1071 (95 % CI - 3146;-87) per person).
  
  
  CONCLUSIONS
  Annual hypertension screening and treatment in women with a history of preeclampsia may save costs, for at least a similar quality of life and survival due to prevented CVD compared with standard care.
authors.affiliation: Department of Cardiology, Isala Klinieken, 8000, PO Box 10500, GM Zwolle, the Netherlands. j.t.drost@isala.nl.
authors.forename: J T
authors.initials: JT
authors.lastname: Drost
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: J P C
authors.initials: JP
authors.lastname: Grutters
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: G-J
authors.initials: GJ
authors.lastname: van der Wilt
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.affiliation: Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: A H E M
authors.initials: AH
authors.lastname: Maas
keywords: Cardiovascular screening; Economic analysis; Preeclampsia