Effectiveness and cost-effectiveness of blood pressure screening in adolescents in the United States.
J Pediatr
; 158(2): 257-64.e1-7, 2011 Feb.
Article
em En
| MEDLINE
| ID: mdl-20850759
ABSTRACT
OBJECTIVE:
To compare the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents in the United States no intervention, "screen-and-treat," and population-wide strategies to lower the entire BP distribution. STUDYDESIGN:
We used a simulation model to combine several data sources to project the lifetime costs and cardiovascular outcomes for a cohort of 15-year-old U.S. adolescents under different BP approaches and conducted cost-effectiveness analysis. We obtained BP distributions from the National Health and Nutrition Examination Survey 1999-2004 and used childhood-to-adult longitudinal correlation analyses to simulate the tracking of BP. We then used the coronary heart disease policy model to estimate lifetime coronary heart disease events, costs, and quality-adjusted life years (QALY).RESULTS:
Among screen-and-treat strategies, finding and treating the adolescents at highest risk (eg, left ventricular hypertrophy) was most cost-effective ($18000/QALY [boys] and $47000/QALY [girls]). However, all screen-and-treat strategies were dominated by population-wide strategies such as salt reduction (cost-saving [boys] and $650/QALY [girls]) and increasing physical education ($11000/QALY [boys] and $35000/QALY [girls]).CONCLUSIONS:
Routine adolescents BP screening is moderately effective, but population-based BP interventions with broader reach could potentially be less costly and more effective for early cardiovascular disease prevention and should be implemented in parallel.
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Programas de Rastreamento
/
Redução de Custos
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Doença das Coronárias
/
Hipertensão
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Health_economic_evaluation
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
/
Screening_studies
Aspecto:
Patient_preference
Limite:
Adolescent
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Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos