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 "The increased cost burden of hypertension may cause some patients
to discontinue antihypertensive medication," especially if they
don't have insurance coverage for prescription drugs, Dr. Robert M.
Carey of the University of Virginia School of Medicine, who was not
involved in the study, said by email.
Nationally, healthcare for adults with high blood pressure, or
hypertension, costs an extra $131 billion per year, according to Dr.
Elizabeth B. Kirkland of the Medical University of South Carolina in
Charleston and colleagues.
Kirkland's team used data from the Medical Expenditure Panel Survey
to analyze 12 years of medical expenditures for nearly 225,000
adults, about a third of whom had hypertension.
From 2003 to 2014, compared to adults without hypertension, those
with the condition averaged $1,920 more in annual healthcare costs,
the researchers reported in the Journal of the American Heart
Association.
People with hypertension had two-and-a-half times the inpatient
costs, nearly double the outpatient costs, and nearly triple the
prescription medication costs of their peers without high blood
pressure.
The researchers did not analyze what part of these costs was paid by
insurance and what part patients paid directly out of pocket.
Kirkland told Reuters Health by email that expenditures associated
with hypertension seem to be shifting from inpatient to outpatient
settings.
"This may indicate that with progressively better control of
hypertension over time, we are beginning to see a reduction in the
(complications) resulting from uncontrolled blood pressure," Carey
said.
In patients with hypertension, the force of blood pushing against
the blood vessels is too high. Over time, this sustained pressure
damages the arteries and heart and leads to other serious health
concerns.
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High blood pressure often has no symptoms. As a result, patients
might delay or skip treatment, said Dr. Paul Heidenreich of Stanford
University School of Medicine in California, who was not involved
with the study.
"The consequences are long-term, leading to more heart disease,
stroke and kidney disease," he said in an email.
Last year, the American Heart Association, the American College of
Cardiology and several other health organizations lowered the
threshold for high blood pressure in adults to 130/80 millimeters of
mercury. The first number, the systolic blood pressure, is the
pressure blood exerts against artery walls when the heart beats. The
second number, the diastolic pressure, is the pressure blood exerts
on artery walls during the pauses between heartbeats. Previous
guidelines had set the threshold at 140/90 mm Hg or higher.
The proportion of American adults with hypertension rose from 32
percent to 46 percent - or 103 million people - under the new
guideline, according to the American Heart Association.
Kirkland's analysis does not account for that new, lower threshold.
But she says it will increase the number of people in the affected
population, which in turn will likely increase the overall societal
cost. On the flip side, it may lower the average per patient cost,
since patients on the lower end of that range may be able to control
their blood pressure with changes to diet and exercise instead of
new medications.
SOURCE: http://bit.ly/2JHdWOr Journal of the American Heart
Association, online May 30, 2018.
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