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高血压诱发心血管病的风险以及治疗高血压的真正疗效的许多流行病学定量证据,是从大量临床试验得到的。因此,高血压可成为成本-效果分析的良好的模型。在Framingham的计算结果发现,男性高血压患者(血压>160/95mmHg)心血管病死亡率此正常血压男性(血压<140/90mmHg)的高2.8倍,妇女高血压患者心血管病死亡率此正常血压的妇女高2.3倍,高血压对男女都有相当危险性,但是男子的绝对风险比妇女高。高血压是诱发冠心病的最大绝对风险(144次/10000男子/年),高血压是诱发卒中的最大相对风险(约为700％)。从Framingham的资料计算得到:一个社区中高血压完全逆转者18年中冠心病发病率约下降63％。卒中发病率下降87％。高血压治疗的大量临床试验的Meta分析表明,治疗率中死亡率下降38％,冠心病死亡率下降8％。因此,实际疗效虽然明显,但与可能达到的理想疗效还不相匹配,其中一个原因是治疗可能产生对冠心病其他危险因素的副作用。所有这些因素包括影响生命质量的副作用的发生率,在对高血压治疗成本-效果进行分析时需要注意。
Many epidemiological quantitative evidence of the risk of hypertension-induced cardiovascular disease and the true efficacy of treatment for hypertension have been obtained from a large number of clinical trials. Therefore, high blood pressure can be a good model for cost-effectiveness analysis. In Framingham’s calculations, cardiovascular mortality in men with hypertension (BP> 160/95 mm Hg) was 2.8 times higher than that of men with normal blood pressure (BP <140/90 mm Hg), and this was normal for women with hypertensive cardiovascular disease High blood pressure 2.3 times higher women, men and women have high risk of hypertension, but the absolute risk of men higher than women. Hypertension is the absolute absolute risk of developing coronary heart disease (144 beats / 10,000 men / year) and hypertension is the maximum relative risk of stroke (about 700%). Calculated from Framingham’s data: Coronary hypertension was approximately 63% less likely to occur at 18 years in a community with a complete reversal of hypertension. The incidence of stroke decreased 87%. Meta-analysis of a large number of clinical trials of hypertension treatment showed a 38% reduction in mortality and a 8% reduction in coronary heart disease mortality. Therefore, although the actual therapeutic effect is obvious, one of the reasons for this may not be matched with the ideal therapeutic effect that may be achieved is that the treatment may have side effects on other risk factors of coronary heart disease. All of these factors include the incidence of side effects that affect quality of life and care needs to be taken when analyzing the cost-effectiveness of treatment for hypertension.