Witham M D, Davies J I, Dawson A, Davey P G, Struthers A D
Section of Ageing and Health, Ninewells Hospital and Medical School, Dundee, UK.
QJM. 2004 Feb;97(2):87-93. doi: 10.1093/qjmed/hch016.
Left ventricular hypertrophy (LVH) measured by echocardiography is a powerful independent marker of increased cardiovascular risk. The prevalence of echocardiographic LVH in patients with high cardiovascular risk appears to be high, even in patients currently considered normotensive.
To ascertain the likely costs of screening for and treating echocardiographic LVH in normotensive patients at high risk of cardiovascular events.
Hypothetical economic analysis.
Cost analyses were based on known costs of echocardiography, costs of selected cardiovascular medications and prevalence of normotensive LVH in at-risk populations, combined with treatment effect data from studies of hypertensive patients with echocardiographic LVH.
Screening costs per case for echocardiographic LVH are likely to be low, because of the high prevalence of the condition and the low unit cost of echocardiography. Treatment costs are likely to be comparable to those currently deemed acceptable in treating high-risk cardiovascular populations, e.g. the HOPE study population.
The costs of screening for and treating LVH in normotensive patients at risk of cardiovascular events do not appear to be prohibitively high. Trials of screening and treatment for normotensive LVH seem therefore to be warranted.
通过超声心动图测量的左心室肥厚（LVH）是心血管风险增加的一个有力独立标志物。即使在目前被认为血压正常的患者中，具有高心血管风险的患者中超声心动图检测到LVH的患病率似乎也很高。
确定对心血管事件高风险的血压正常患者进行超声心动图LVH筛查和治疗的可能成本。
假设性经济分析。
成本分析基于超声心动图的已知成本、选定心血管药物的成本以及高危人群中血压正常的LVH患病率，并结合来自超声心动图检测到LVH的高血压患者研究的治疗效果数据。
由于该病症的高患病率和超声心动图的低单位成本，超声心动图LVH的每例筛查成本可能较低。治疗成本可能与目前认为可接受的治疗高危心血管人群（如HOPE研究人群）的成本相当。
对有心血管事件风险的血压正常患者进行LVH筛查和治疗的成本似乎并非高得令人望而却步。因此，对血压正常的LVH进行筛查和治疗的试验似乎是有必要的。
