Ferguson R K
Ann Intern Med. 1975 Jun;82(6):761-5. doi: 10.7326/0003-4819-82-6-761.
During the first 5 years of a community-based referral hypertension clinic, 331 ambulatory patients referred for diagnostic evaluation. Thirty-four patients were judged to be normotensive on the basis of resting blood pressures on 3 separate days. In 51 patients the diagnosis was borderline hypertension and 220, essential hypertension. Twenty-six patients (10.6%) had secondary hypertension. Twenty-one patients with secondary hypertension were first recognized from the data of the history, physical examination, and routine urinalysis. The main cost per patient of the initial and further evaluations was computed for each group of patients. The average cost to identify one case of secondary hypertension in the clinic was $2083. Because of the large problem with hypertension in the United States today, the cost-effectiveness of various approaches to the evaluation of patients with hypertension requires thoughtful reappraisal.
在一家社区转诊高血压诊所的头5年里，有331名门诊患者被转诊进行诊断评估。根据3个不同日子的静息血压，34名患者被判定为血压正常。51名患者的诊断为临界高血压，220名患者为原发性高血压。26名患者（10.6%）患有继发性高血压。21名继发性高血压患者最初是从病史、体格检查和常规尿液分析的数据中识别出来的。计算了每组患者初次评估和进一步评估的人均主要费用。在该诊所识别一例继发性高血压的平均费用为2083美元。鉴于当今美国高血压问题严重，对高血压患者进行评估的各种方法的成本效益需要进行深入重新评估。
