Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study.
The PAST-BP trial found that using a lower systolic blood pressure target (<130 mmHg or lower versus <140 mmHg) in a primary care population with prevalent cerebrovascular disease was associated with a small additional reduction in blood pressure (2.9 mmHg).To determine the cost effect...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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SAGE Publications
2016
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| _version_ | 1797077160477851648 |
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| author | Penaloza-Ramos, M Jowett, S Barton, P Roalfe, A Fletcher, K Taylor, C Hobbs, F McManus, R Mant, J |
| author_facet | Penaloza-Ramos, M Jowett, S Barton, P Roalfe, A Fletcher, K Taylor, C Hobbs, F McManus, R Mant, J |
| author_sort | Penaloza-Ramos, M |
| collection | OXFORD |
| description | The PAST-BP trial found that using a lower systolic blood pressure target (<130 mmHg or lower versus <140 mmHg) in a primary care population with prevalent cerebrovascular disease was associated with a small additional reduction in blood pressure (2.9 mmHg).To determine the cost effectiveness of an intensive systolic blood pressure target (<130 mmHg or lower) compared with a standard target (<140 mmHg) in people with a history of stroke or transient ischaemic attack on general practice stroke/transient ischaemic attack registers in England.A Markov model with a one-year time cycle and a 30-year time horizon was used to estimate the cost per quality-adjusted life year of an intensive target versus a standard target. Individual patient level data were used from the PAST-BP trial with regard to change in blood pressure and numbers of primary care consultations over a 12-month period. Published sources were used to estimate life expectancy and risks of cardiovascular events and their associated costs and utilities.In the base-case results, aiming for an intensive blood pressure target was dominant, with the incremental lifetime costs being £169 lower per patient than for the standard blood pressure target with a 0.08 quality-adjusted life year gain. This was robust to sensitivity analyses, unless intensive blood pressure lowering reduced quality of life by 2% or more.Aiming for a systolic blood pressure target of <130 mmHg or lower is cost effective in people who have had a stroke/transient ischaemic attack in the community, but it is difficult to separate out the impact of the lower target from the impact of more active management of blood pressure. |
| first_indexed | 2024-03-07T00:13:53Z |
| format | Journal article |
| id | oxford-uuid:7a2c9634-771b-4542-b90b-de8c180de377 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:13:53Z |
| publishDate | 2016 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:7a2c9634-771b-4542-b90b-de8c180de3772022-03-26T20:42:09ZCost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7a2c9634-771b-4542-b90b-de8c180de377EnglishSymplectic Elements at OxfordSAGE Publications2016Penaloza-Ramos, MJowett, SBarton, PRoalfe, AFletcher, KTaylor, CHobbs, FMcManus, RMant, JThe PAST-BP trial found that using a lower systolic blood pressure target (<130 mmHg or lower versus <140 mmHg) in a primary care population with prevalent cerebrovascular disease was associated with a small additional reduction in blood pressure (2.9 mmHg).To determine the cost effectiveness of an intensive systolic blood pressure target (<130 mmHg or lower) compared with a standard target (<140 mmHg) in people with a history of stroke or transient ischaemic attack on general practice stroke/transient ischaemic attack registers in England.A Markov model with a one-year time cycle and a 30-year time horizon was used to estimate the cost per quality-adjusted life year of an intensive target versus a standard target. Individual patient level data were used from the PAST-BP trial with regard to change in blood pressure and numbers of primary care consultations over a 12-month period. Published sources were used to estimate life expectancy and risks of cardiovascular events and their associated costs and utilities.In the base-case results, aiming for an intensive blood pressure target was dominant, with the incremental lifetime costs being £169 lower per patient than for the standard blood pressure target with a 0.08 quality-adjusted life year gain. This was robust to sensitivity analyses, unless intensive blood pressure lowering reduced quality of life by 2% or more.Aiming for a systolic blood pressure target of <130 mmHg or lower is cost effective in people who have had a stroke/transient ischaemic attack in the community, but it is difficult to separate out the impact of the lower target from the impact of more active management of blood pressure. |
| spellingShingle | Penaloza-Ramos, M Jowett, S Barton, P Roalfe, A Fletcher, K Taylor, C Hobbs, F McManus, R Mant, J Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title | Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title_full | Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title_fullStr | Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title_full_unstemmed | Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title_short | Cost-effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack: Economic analysis of the PAST-BP study. |
| title_sort | cost effectiveness analysis of different systolic blood pressure targets for people with a history of stroke or transient ischaemic attack economic analysis of the past bp study |
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