Table 2.
Annual population treated and cost-effectiveness of implementing JNC 8 hypertension treatment guidelines in previously untreated non-Hispanic black (NHB) and non-Hispanic white (NHW) adults with hypertension aged 35–74 years. Average annual results from a years 2014–2024 simulation, the CVD policy model.
| Strategy | Annual incremental results | ||||
|---|---|---|---|---|---|
| Number of people newly treated | CVD events averted compared with status quo | CVD costs compared with status quo ($US, thousands) | ICER compared with status quo ($US per QALY gained) | ICER compared with prior strategy ($US per QALY gained) | |
| NHB patients | |||||
| NHB women ages 35–74 years | |||||
| Treat CVD population | 35,000 | −1,000 (1,000; 1,000) | −48,000 (−70,000; −31,000) | Cost savinga | Cost savinga |
| Treat stage 2 along with CVD | 484,000 | −2,000 (2,000; 3,000) | −103,000 (−142,000; −73,000) | Cost savinga | Cost savinga |
| Treat stage 1 with diabetes or CKD, along with CVD and stage 2 | 703,000 | −3,000 (2,000; 3,000) | −112,000 (−157,000; −76,000) | Cost savinga | Cost savinga |
| Treat all hypertension | 855,000 | −3,000 (3,000; 4,000) | −115,000 (−164,000; −76,000) | Cost savinga | Cost saving (cost saving; 4,000) |
| NHB men ages 35–74 years | |||||
| Treat CVD population | 96,000 | −1,000 (1,000; 2,000) | −100,000 (−148,000; −67,000) | Cost savinga | Cost savinga |
| Treat stage 2 along with CVD | 592,000 | −4,000 (3,000; 5,000) | −258,000 (−336,000; −193,000) | Cost savinga | Cost savinga |
| Treat stage 1 with diabetes or CKD, along with CVD and stage 2 | 698,000 | −4,000 (4,000; 6,000) | −294,000 (−386,000; −219,000) | Cost savinga | Cost savinga |
| Treat all hypertension | 940,000 | −5,000 (4,000; 7,000) | −337,000 (−446,000; −244,000) | Cost savinga | Cost savinga |
| NHW patients | |||||
| NHW women ages 35–74 years | |||||
| Treat CVD population | 86,000 | −4,000 (3,000; 5,000) | −163,000 (−240,000; −105,000) | Cost savinga | Cost savinga |
| Treat stage 2 along with CVD | 785,000 | −10,000 (8,000; 12,000) | −286,000 (−431,000; −160,000) | Cost savinga | Cost savinga |
| Treat stage 1 with diabetes or CKD, along with CVD and stage 2 | 1,527,000 | −11,000 (9,000; 13,000) | −273,000 (−440,000; −130,000) | Cost savinga | 6,000 (−4,000; 18,000) |
| Treat all hypertension | 2,559,000 | −13,000 (10,000; 15,000) | −203,000 (−399,000; −43,000) | Cost savinga | 19,000 (9,000; 31,000) |
| NHW men ages 35–74 years | |||||
| Treat CVD population | 482,000 | −6,000 (5,000; 8,000) | −455,000 (−702,000; −292,000) | Cost savinga | Cost savinga |
| Treat stage 2 along with CVD | 1,368,000 | −16,000 (12,000; 20,000) | −884,000 (−1,269,000; −597,000) | Cost savinga | Cost savinga |
| Treat stage 1 with diabetes or CKD, along with CVD and stage 2 | 1,961,000 | −19,000 (14,000; 24,000) | −964,000 (−1,399,000; −632,000) | Cost savinga | Cost savinga |
| Treat all hypertension | 3,436,000 | −22,000 (18,000; 28,000) | −971,000 (−1,473,000; −581,000) | Cost savinga | Cost savinga |
Abbreviations: CKD = chronic kidney disease; CVD = cardiovascular disease; ICER = incremental cost-effectiveness ratio; QALY = quality-adjusted life year.
aUpper and lower uncertainty interval bounds of ICERs were cost saving.