Cost-effectiveness of nitrendipine and hydrochlorothiazide or metoprolol to treat hypertension in rural community health centers in China

被引:4
作者
Wang, Zengwu [1 ,2 ]
Chen, Zuo [1 ,2 ]
Wang, Xin [1 ,2 ]
Hao, Guang [3 ]
Ma, Liyuan [2 ,4 ]
Zhao, Xin [5 ]
Li, Yang [6 ]
Zhang, Linfeng [1 ,2 ]
Zhu, Manlu [1 ,2 ]
机构
[1] Peking Union Med Coll, Div Prevent & Community Hlth, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China
[2] Chinese Acad Med Sci, 167 Beilishi Rd, Beijing 100037, Peoples R China
[3] Augusta Univ, Med Coll Georgia, Georgia Prevent Inst, Augusta, GA USA
[4] Peking Union Med Coll, Div Informat Consultat, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Beijing, Peoples R China
[5] Jilin Univ, Hosp 1, Dept Dept Cardiol, Changchun, Jilin, Peoples R China
[6] Chinese Acad Med Sci, Inst Med Informat, Beijing, Peoples R China
关键词
beta-blockers; calcium channel blocker; costeffectiveness; diuretics; hypertension; treatment; MANAGEMENT; RISK; THERAPY; PROGRAM; DISEASE;
D O I
10.1097/HJH.0000000000001209
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objectives: The objective of this article is to compare blood pressure (BP)-lowing effects of nitrendipine and hydrochlorothiazide and nitrendipine and metoprolol, and estimate the economic effect of these therapies on hypertension. Methods: Outpatients (N = 793) 18-70 years of age with stage 2 or severe hypertension (SBP >= 160 mmHg and/or DBP >= 100 mmHg) were recruited from four randomly selected rural community health centers in Beijing and Jilin. After drug wash out, they were randomly divided into nitrendipine and hydrochlorothiazide group or nitrendipine and metoprolol group. The costs of drug treatment for hypertension were calculated and general estimation, whereas effectiveness was measured as a reduction in SBP and DBP at the end of a 24-week study period. Results: Overall, 623 patients were eligible for the study and after a 24-week follow-up, SBP and DBP were 131.2/ 82.2 mmHg for the nitrendipine and hydrochlorothiazide group and 131.4/82.9mmHg for the nitrendipine and metoprolol group and these were not significantly different (P = 0.7974 SBP and P = 0.1166 DBP). Comparing with nitrendipine and metoprolol, the cost of nitrendipine and hydrochlorothiazide was less, and its effectiveness was similar. The cost/effect ratio (US$/mmHg) was 1.4 for SBP and 2.8 for DBP for the nitrendipine and hydrochlorothiazide group, and 1.9 and 3.8 for the nitrendipine and metoprolol group's SBP and DBP values, respectively. The incremental cost per patient for achieving target BP was 5.1. Adverse events were mild or moderate and there were no differences between treatment groups. Conclusion: Treating hypertension with nitrendipine and hydrochlorothiazide was cost-effective than nitrendipine and metoprolol, and these data will allow more reasonable and efficient allocation of limited resources in low-income countries.
引用
收藏
页码:886 / 892
页数:7
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