The economic impact of the introduction of home blood pressure measurement for the diagnosis and treatment of hypertension

Jin Funahashi, Takayoshi Ohkubo, Hidefumi Fukunaga, Masahiro Kikuya, Noriko Takada, Kei Asayama, Hirohito Metoki, Taku Obara, Ryusuke Inoue, Junichiro Hashimoto, Kazuhito Totsune, Makoto Kobayashi, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

Abstract

OBJECTIVES: To investigate the economic consequences resulting from introduction of home blood pressure measurement in diagnosis of hypertension instead of casual clinic blood pressure measurement. METHODS: We constructed a decision tree model using data from the Ohasama study and a Japanese national database. The Ohasama study provided the prognostic value of home blood pressure as compared with clinic blood pressure measurement. RESULTS: It is predicted that the use of home blood pressure for hypertension diagnosis results in a saving of 9.30 billion US dollars (1013.6 billion yen) in hypertension-related medical costs in Japan. Most of this was attributable to medical costs saved by avoiding the start of treatment for untreated individuals who were diagnosed as hypertensive by clinic blood pressure but whose blood pressures were in the normal range when based on home blood pressure; that is, the so called white-coat hypertension. Furthermore, it could be expected that adequate blood pressure control mediated by the change in the diagnostic method from clinic to home blood pressure measurement would improve the prognosis for hypertension. We estimated that the prevention of hypertensive complications resulted in a reduction of annual medical costs by 28 million US dollars (3.0 billion yen). In addition, stroke prevention due to adequate blood pressure control based on home blood pressure measurement reduced annual long-term care costs by 39 million US dollars (4.2 billion yen). A per-person break-even cost for introducing home blood pressure monitoring was calculated as 409 US dollars (44 580 yen). CONCLUSIONS: The introduction of home blood pressure measurement for the diagnosis and treatment of hypertension would be very effective to save costs.

Original languageEnglish
Pages (from-to)257-267
Number of pages11
JournalBlood pressure monitoring
Volume11
Issue number5
DOIs
Publication statusPublished - 2006 Oct

Keywords

  • Cost analysis
  • Home blood pressure
  • Hypertension
  • Medical costs
  • Ohasama study

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialised Nursing

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