Cost-effectiveness of nitrendipine and hydrochlorothiazide or metoprolol to treat hypertension in rural community health centers in China

Autor: Guang Hao, Xin Wang, Zengwu Wang, Yang Li, Linfeng Zhang, Zuo Chen, Xin Zhao, Liyuan Ma, Manlu Zhu
Rok vydání: 2017
Předmět:
Male
calcium channel blocker
Physiology
Cost effectiveness
Cost-Benefit Analysis
Blood Pressure
030204 cardiovascular system & hematology
Pharmacology
law.invention
0302 clinical medicine
Hydrochlorothiazide
Randomized controlled trial
Nitrendipine
law
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Metoprolol
treatment
Health Care Costs
Middle Aged
Beijing
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Cardiology
Drug Therapy
Combination
Female
Cardiology and Cardiovascular Medicine
ORIGINAL PAPERS: Therapeutic aspects
circulatory and respiratory physiology
medicine.drug
Adult
medicine.medical_specialty
hypertension
Adolescent
Young Adult
03 medical and health sciences
Internal medicine
Internal Medicine
medicine
Humans
cardiovascular diseases
Adverse effect
cost-effectiveness
Antihypertensive Agents
Aged
business.industry
Community Health Centers
diuretics
Blood pressure
β-blockers
Rural Health Services
business
Zdroj: Journal of Hypertension
ISSN: 0263-6352
DOI: 10.1097/hjh.0000000000001209
Popis: Supplemental Digital Content is available in the text
Objectives: The objective of this article is to compare blood pressure (BP)-lowing effects of nitrendipine and hydrochlorothiazide and nitrendipine and metoprolol, and estimate the economic effect of these therapies on hypertension. Methods: Outpatients (N = 793) 18–70 years of age with stage 2 or severe hypertension (SBP ≥ 160 mmHg and/or DBP ≥ 100 mmHg) were recruited from four randomly selected rural community health centers in Beijing and Jilin. After drug wash out, they were randomly divided into nitrendipine and hydrochlorothiazide group or nitrendipine and metoprolol group. The costs of drug treatment for hypertension were calculated and general estimation, whereas effectiveness was measured as a reduction in SBP and DBP at the end of a 24-week study period. Results: Overall, 623 patients were eligible for the study and after a 24-week follow-up, SBP and DBP were 131.2/82.2 mmHg for the nitrendipine and hydrochlorothiazide group and 131.4/82.9 mmHg for the nitrendipine and metoprolol group and these were not significantly different (P = 0.7974 SBP and P = 0.1166 DBP). Comparing with nitrendipine and metoprolol, the cost of nitrendipine and hydrochlorothiazide was less, and its effectiveness was similar. The cost/effect ratio (US$/mmHg) was 1.4 for SBP and 2.8 for DBP for the nitrendipine and hydrochlorothiazide group, and 1.9 and 3.8 for the nitrendipine and metoprolol group's SBP and DBP values, respectively. The incremental cost per patient for achieving target BP was 5.1. Adverse events were mild or moderate and there were no differences between treatment groups. Conclusion: Treating hypertension with nitrendipine and hydrochlorothiazide was cost-effective than nitrendipine and metoprolol, and these data will allow more reasonable and efficient allocation of limited resources in low-income countries.
Databáze: OpenAIRE
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