Predicting Out-of-Office Blood Pressure in the Clinic for the Diagnosis of Hypertension in Primary CareNovelty and Significance [Prediction of Out-of-Office Blood Pressure]

This study assessed the cost-effectiveness of using this tool in diagnosing hypertension in primary care. A Markov cost–utility cohort model was developed to compare diagnostic strategies: the PROOF-BP approach, including those with clinic BP ≥130/80 mm Hg who receive ambulatory BP monitoring as guided by the algorithm, compared with current standard diagnostic strategies including those with clinic BP ≥140/90 mm Hg combined with further monitoring (ambulatory BP monitoring as reference, clinic, and home monitoring also assessed). The model adopted a lifetime horizon with a 3-month time cycle, taking a UK Health Service/Personal Social Services perspective. The PROOF-BP algorithm was cost-effective in screening all patients with clinic BP ≥130/80 mm Hg compared with current strategies that only screen those with clinic BP ≥140/90 mm Hg, provided healthcare providers were willing to pay up to £20 000 ($26 000)/quality-adjusted life year gained. Deterministic and probabilistic sensitivity analyses supported the base-case findings. The PROOF-BP algorithm seems to be cost-effective compared with the conventional BP diagnostic options in primary care. Its use in clinical practice is likely to lead to reduced cardiovascular disease, death, and disability.

Source: Hypertension - January 10, 2018 Category: Cardiology Authors: Mark Monahan, Sue Jowett, Kate Lovibond, Paramjit Gill, Marshall Godwin, Sheila Greenfield, Janet Hanley, F.D. Richard Hobbs, Una Martin, Jonathan Mant, Brian McKinstry, Bryan Williams, James P. Sheppard, Richard J. McManus Tags: High Blood Pressure, Hypertension, Cost-Effectiveness Original Articles Source Type: research