| Summary: | <p>Abstract</p> <p>Background</p> <p>In practice, it is difficult to compare the effectiveness of traditional antihypertensive treatment with that of health promotion in reducing incidence rate of cardiovascular disease (IR<sub>CVD</sub>, events/year). This simulation study compared the effectiveness of two approaches to reducing IR<sub>CVD </sub>in a sample population: a traditional approach, in which high-risk patients are treated with conventional antihypertensive medications, and a population-based approach, in which subjects participate in a health promotion program.</p> <p>Methods</p> <p>We constructed a simulation model for a sample population of middle-aged Japanese men whose systolic blood pressure (SBP) levels are normally distributed (130 ± 20 mm Hg). The principal assumption was that IR<sub>CVD </sub>increases exponentially according to SBP. The population IR<sub>CVD </sub>was calculated as the product of the distribution of SBP multiplied by IR<sub>CVD </sub>at each SBP. The cumulative IR<sub>CVD </sub>was calculated by the definite integral from the lowest to the highest SBP of IR<sub>CVD </sub>at each SBP level. The success rates were calculated according to SBP and metabolic risk profiles in the two approaches, respectively.</p> <p>Results</p> <p>The reduction in IR<sub>CVD </sub>was twice as large for antihypertensive medications as it was for health promotion in several situations. For example, if adherence to antihypertensive treatment occurred at a realistic level, the decrease in IR<sub>CVD </sub>was estimated at 9.99 × 10<sup>-4</sup>. In contrast, even if the health program was promoted optimistically, the decrease in IR<sub>CVD </sub>was estimated at 4.69 × 10<sup>-4</sup>.</p> <p>Conclusions</p> <p>The success rate-oriented simulation suggests that prescribing antihypertensive medications is superior to promoting the health promotion program in reducing IR<sub>CVD </sub>in virtual middle-aged Japanese men.</p>
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