title: Challenges of the epidemiological and economic burdens associated with hypertension in middle income countries: evidence from Mexico.
abstract: BACKGROUND
  In order to identify the challenges resulting from hypertension in a middle income country, this study has developed probabilistic models to determine the epidemiological and economic burden of hypertension in Mexico.
  
  
  METHODS
  Considering a population base of 654,701 reported cases of adults with hypertension, we conducted a longitudinal analyses in order to identify the challenges of epidemiological changes and health care costs for hypertension in the Mexican health system. The cost-evaluation method used was based on the instrumentation technique. To estimate the epidemiological changes for 2015-2017, probabilistic models were constructed according to the Box-Jenkins technique.
  
  
  RESULTS
  Regarding changes in expected cases for 2015 vs. 2017, an increase of 12 % is expected (p < 0.001). Comparing the economic impact in 2015 versus 2017 (p < 0.001), there is a 23 % increase in financial requirements. The total amount for hypertension in 2016 (US dollars) will be $6306,685,320 Of these, $ 2990,109,035 will be as direct costs and $ 3316,576,285 as indirect costs.
  
  
  CONCLUSIONS
  If the risk factors and care models remain as they are currently in the health system, the financial consequences will have a major impact on the out-of-pocket users, following in order of importance, on social security providers and on public assistance providers.
authors.affiliation: National Institute of Public Health-Mexico, School of Public Health, University of Montreal, Cuernavaca, QC, H3T 1 J4, Mexico. armando.arredondo@insp.mx.|National Institute of Public Health, Av Universidad 655, CP 62508, Cuernavaca, Mexico. armando.arredondo@insp.mx.
authors.forename: Armando
authors.initials: A
authors.lastname: Arredondo
authors.affiliation: National Institute of Public Health, Av Universidad 655, CP 62508, Cuernavaca, Mexico. magali.cuadra@insp.mx.
authors.forename: Silvia Magali
authors.initials: SM
authors.lastname: Cuadra
authors.affiliation: National Institute of Public Health, Av Universidad 655, CP 62508, Cuernavaca, Mexico. beatriz.duarte@insp.mx.
authors.forename: Maria Beatriz
authors.initials: MB
authors.lastname: Duarte
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000191:economics* / Q000453:epidemiology*; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012307:Risk Factors