Cost-effectiveness of the introduction of home blood pressure measurement in patients with office hypertension

J Hypertens. 2008 Apr;26(4):685-90. doi: 10.1097/HJH.0b013e3282f42285.


Objective: Cost-effectiveness of hypertension treatment is an important social and medical issue in Western as well as in Eastern countries, including Japan. Home blood pressure (HBP) measurements have a stronger predictive power for cardiovascular events than casual clinic blood pressure (CBP) measurements. Therefore, the introduction of HBP measurement for the diagnosis and treatment of hypertension should lead to a decrease in medical expenditure. This study presents calculations of the cost savings likely to take place when HBP is implemented for newly detected hypertensive subjects in Japan.

Design and methods: We estimate the cost savings from the perspective of a Japanese healthcare system. To estimate the costs associated with changing from CBP to HBP measurement as the diagnostic tool, we constructed a simulation model using data from the Ohasama study. These calculations are based on current estimates for cost of treatment, prevalence of white-coat hypertension at baseline, and varying the incidence of new hypertension after the initial screening.

Results: When HBP measurement is not incorporated into the diagnostic process, the medical cost is estimated at US$10.89 million per 1000 subjects per 5 years. When HBP measurement is incorporated, the medical cost is estimated at US$9.33 million per 1000 subjects per 5 years. The reductions in medical costs vary from US$674,000 to US$2.51 million per 1000 subjects per 5 years for treatment of hypertension, when sensitivity analysis is performed.

Conclusions: The introduction of HBP measurement for the treatment of hypertension is very useful for reducing medical costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure Monitoring, Ambulatory / economics*
  • Blood Pressure Monitoring, Ambulatory / statistics & numerical data
  • Cost Savings*
  • Cost-Benefit Analysis
  • Humans
  • Hypertension / diagnosis
  • Hypertension / economics*
  • Hypertension / epidemiology
  • Incidence
  • Japan / epidemiology
  • National Health Programs / economics*
  • Physicians' Offices
  • Sensitivity and Specificity