September 1, 1993Journal of Internal Medicine
The cost‐effectiveness of treating hypertension in elderly people—an analysis of the Swedish Trial in Old Patients with Hypertension (STOP Hypertension)
Key result
Antihypertensive treatment with beta blockers and diuretics in elderly patients was cost-effective, with an estimated cost per life-year gained of SEK 5,000 for men and SEK 15,000 for women.
Why the study?
Is antihypertensive treatment with beta blockers and diuretics cost-effective in elderly hypertensive patients?
Population
1627 hypertensive patients aged 70-84 across 116 primary health care centres in Sweden.
Comparison
Antihypertensive treatment with beta blockers… vs Placebo.
Design
Other, Randomized
Follow-up
mean 25 months
Authors
Discussion
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Implication
Supports beta-blocker/diuretic use in elderly hypertension as cost-effective; leaves open applicability to contemporary regimens and populations.
Key Points
- The study aims to evaluate the cost-effectiveness of treating hypertension in elderly individuals.
- Randomized trial comparing active treatment and placebo.
- Involved 1627 hypertensive patients aged 70-84 across 116 health care centers.
- Treatment included beta blockers and diuretics over a mean follow-up of 25 months.
- Cost per life-year gained was SEK 5000 for men and SEK 15,000 for women.
- Cost-effectiveness did not exceed SEK 100,000 in sensitivity analyses.
- Significant reductions in risk of stroke, cardiovascular disease, and total mortality were observed.
Study Design
Type
RCT (n=1,627)
Randomization
randomized
Multicenter
Yes
Structured PICO
Is antihypertensive treatment with beta blockers and diuretics cost-effective in elderly hypertensive patients?
P
Population
1,627 hypertensive patients aged 70-84 from 116 primary health care centres in Sweden, followed for a mean of 25 months.
I
Intervention
Antihypertensive treatment with beta blockers and diuretics for a mean follow-up of 25 months.
C
Comparator
Placebo.
O
Outcome
Cost-effectiveness ratio estimated as the net cost (treatment cost minus saved costs of reduced cardiovascular morbidity) divided by the number of life-years gained.
Treating elderly hypertensive patients with beta blockers and/or diuretics is highly cost-effective, with a low cost per life-year gained.
Cite This Study
Johannesson et al. (1993) conducted an RCT in hypertension (n=1,627). Antihypertensive treatment with beta blockers and diuretics vs. placebo was evaluated on Cost-effectiveness ratio (net cost divided by life-years gained). Antihypertensive treatment with beta blockers and diuretics in elderly patients was cost-effective, with an estimated cost per life-year gained of SEK 5,000 for men and SEK 15,000 for women.