Ambulatory BP Monitoring Cost-Effective Diagnostic Strategy

Ambulatory BP monitoring as a diagnostic strategy for hypertension also increases quality-adjusted life years

WEDNESDAY, Aug. 24 (HealthDay News) -- Ambulatory monitoring of blood pressure is the most cost-effective strategy for the diagnosis of hypertension, according to a study published online Aug. 24 in The Lancet.

Kate Lovibond, from the Royal College of Physicians in the United Kingdom, and colleagues compared the cost-effectiveness of different diagnostic strategies for hypertension using Markov model-based probabilistic analysis. A hypothetical primary-care population aged 40 years and older with a screening blood-pressure measurement greater than 140/90 mm Hg and risk-factor prevalence equivalent to the general population was used. Further blood pressure measurements at the clinic, at home, and with an ambulatory monitor were the three diagnostic strategies compared in terms of lifetime costs, quality-adjusted life years, and cost-effectiveness.

The investigators found that ambulatory monitoring was the most cost-effective strategy for diagnosing hypertension in men and women of all ages. Ambulatory monitoring was found to be cost-saving for all groups, and resulted in more quality-adjusted life years for men and women older than 50 years. Assessment with a wide range of deterministic sensitivity analyses around the base case revealed the findings to be robust, but the findings were sensitive if home monitoring was deemed to have equal test performance to ambulatory monitoring or if treatment was judged effective regardless of whether an individual had hypertension.

"Ambulatory monitoring as a diagnostic strategy for hypertension after an initial raised reading in the clinic would reduce misdiagnosis and save costs," the authors write.

One of the study authors disclosed receiving research support in terms of blood pressure devices from Microlife and BpTru.

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