Effectiveness and Cost-Effectiveness of Blood Pressure Screening in Adolescents in the United States

摘要: Objective To compare the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents United States: no intervention, “screen-and-treat,” population-wide strategies lower entire BP distribution. Study design We used a simulation model combine several data sources project lifetime costs cardiovascular outcomes for cohort 15-year-old U.S. under different conducted analysis. obtained distributions from National Health Nutrition Examination Survey 1999–2004 childhood-to-adult longitudinal correlation analyses simulate tracking BP. then coronary heart disease policy estimate events, costs, quality-adjusted life years (QALY). Results Among screen-and-treat strategies, finding treating at highest risk (eg, left ventricular hypertrophy) was most cost-effective ($18000/QALY [boys] $47000/QALY [girls]). However, all were dominated by such as salt reduction (cost-saving $650/QALY [girls]) increasing physical education ($11000/QALY $35000/QALY Conclusions Routine screening is moderately effective, but population-based interventions with broader reach could potentially be less costly more effective early prevention should implemented parallel.