Long-term cost-effectiveness of various initial monotherapies for mild to moderate hypertension

Article Abstract:

Approximately one out of every three persons in the United States has hypertension (high blood pressure), and the medical cost of treatment is estimated to be between eight and $10 billion per year. In recent years, new antihypertensive drugs have become available. While these new drugs may cost ten times as much as traditional treatments such as diuretics, the extra cost may be justified by reduced side effects, more convenient doses, and beneficial effects on blood cholesterol. A cost-benefit analysis of these new antihypertensive drugs was conducted. The authors used a statistical technique called meta-analysis, which identifies many independently-conducted studies on a single topic and reaches a consensus conclusion. All of the 153 studies that were used addressed the effectiveness of various blood pressure drugs on persons from age 35 to 64 with mild to moderate hypertension, but no evidence of coronary artery disease. The cost-benefit analysis showed that propranolol, a beta-adrenergic antagonist, was the most cost-effective initial treatment for mild to moderate hypertension. It also appeared to be the most effective in reducing blood pressure. Another drug, the diuretic hydrochlorothiazide, had a similar cost but only saved 65 percent as many years of life. The drug influence on blood cholesterol was not considered as important as was the ability to lower blood pressure. The authors stressed that meta-analysis can result in substantial errors because it is based on various assumptions which may not hold true in actual clinical trials. Also, the choice of drug treatment should be tailored to the individual patient. Not all persons with the same condition will be equally responsive to any one medication. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Propranolol hydrochloride, Propranolol, Antihypertensive drugs, Antihypertensive agents, Mild hypertension, Essential hypertension

---

Cost effectiveness of thrombolytic therapy with streptokinase in elderly patients with suspected acute myocardial infarction

Article Abstract:

Treatment with streptokinase may be cost-effective and beneficial for elderly patients with a suspected heart attack. Streptokinase is a drug that breaks up blood clots. A mathematical model was used to estimate the probability of death in patients over 75-years-old suspected of having a heart attack. The probability of dying in the hospital was 21.4% for those treated with streptokinase, compared to 24.4% for those not treated with streptokinase. Treatment with streptokinase decreased the risk of dying if the probability that a patient had a heart attack was more than 9%, and if the risk of dying in the hospital from a heart attack was more than 3% without treatment. For an 80-year-old patient with a suspected heart attack, the cost of treatment with streptokinase per year of life saved was an estimated $21,200. The cost of treatment would still be less than $55,000 per year after incorporating the cost of treating complications associated with streptokinase therapy.

Health aspects, Aged, Elderly, Diseases, Heart attack, Streptokinase

---

The recent decline in mortality from coronary heart disease, 1980-1990: the effect of secular trends in risk factors and treatment

Article Abstract:

The decline in mortality rates from coronary heart disease appears to be a result of better care for those with the disease rather than efforts to prevent the disease. According to US statistics, the death rate from coronary heart disease in 1990 was 34% lower than would be predicted by extrapolating from 1980 statistics. However, only 25% to 30% of the decline was attributed to disease prevention, while 70% was attributed to risk reduction and better treatments in those who already had the disease. The percentage of people with the disease is still increasing, however.

Patient outcomes, Mortality, Coronary heart disease, Cardiac patients

Similar abstracts:

• Abstracts: Effect of supplementary feeding on recovery from mild to moderate wasting in preschool children. Nutritional supplementation: effects on child stunting because of diarrhea
• Abstracts: Congenital anomalies in children of patients who received chemotherapy for cancer in childhood and adolescence
• Abstracts: Long-term remission of chronic hepatitis B after alpha-interferon therapy
• Abstracts: Analyzing hospital mortality: the consequences of diversity in patient mix. The importance of severity of illness in assessing hospital mortality
• Abstracts: Survival following diagnosis of Kaposi's sarcoma for AIDS patients in San Francisco. Survival trends for patients with AIDS

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.