Wang Guijing, Yan Lili, Ayala Carma, George Mary G, Fang Jing
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
Am J Hypertens. 2013 Nov;26(11):1295-302. doi: 10.1093/ajh/hpt079. Epub 2013 May 31.
We sought to estimate how much the presence of hypertension adds to annual per capita and total expenditures for medication among US adults.
The sample included 21,782 civilian noninstitutionalized adults aged ≥ 18 years who participated in the 2007 Medical Expenditure Panel Survey. Hypertension was defined as having a diagnosis of high blood pressure (except during pregnancy) or taking a blood pressure medication. We used a 2-part model to examine all-cause medication expenditure associated with hypertension.
The prevalence of hypertension was 32.2%. Overall, 66.7% of adults purchased prescribed medications, with this proportion higher among hypertensive (93.0%) than normotensive (54.4%) adults (P < 0.001). Hypertensive adults were more likely to have medication expenditures than were normotensive adults (odds ratio (OR) = 6.42; P < 0.001). Among hypertensive adults, those aged ≥ 45 years were more likely to incur medication expenditure than those aged 18-44 years (OR = 3.00, P < 0.001 for those aged 45-64 years; OR = 5.95, P < 0.001 for those aged ≥ 65 years), whereas women were 2.91 times as likely as men to have medication spending (P < 0.001). Hispanics were less likely than non-Hispanic whites to have such spending (OR = 0.51; P < 0.001). Among those purchasing medications, the average cost was $1,510 higher among hypertensive persons ($2,337) than normotensive persons ($827). Hypertension-associated expenditures for medication were estimated at $68 billion in the US civilian non-institutionalized population in 2007.
The presence of hypertension among US adults is associated with an increase of all-cause expenditures for medication, with this increase varying across groups by age and sex.
我们试图估算高血压的存在对美国成年人每年人均药物支出和总药物支出的增加幅度。
样本包括21782名年龄≥18岁的非机构化平民成年人,他们参与了2007年医疗支出小组调查。高血压定义为患有高血压诊断(孕期除外)或正在服用降压药。我们使用两部分模型来研究与高血压相关的全因药物支出。
高血压患病率为32.2%。总体而言,66.7%的成年人购买处方药,这一比例在高血压成年人(93.0%)中高于血压正常的成年人(54.4%)(P<0.001)。高血压成年人比血压正常的成年人更有可能产生药物支出(优势比(OR)=6.42;P<0.001)。在高血压成年人中,年龄≥45岁的人比18 - 44岁的人更有可能产生药物支出(45 - 64岁的人OR = 3.00,P<0.001;≥65岁的人OR = 5.95,P<0.001),而女性产生药物支出的可能性是男性的2.91倍(P<0.001)。西班牙裔比非西班牙裔白人产生此类支出的可能性更小(OR = 0.51;P<0.001)。在购买药物的人群中,高血压患者的平均费用(2337美元)比血压正常者(827美元)高出1510美元。2007年,美国非机构化平民人口中与高血压相关的药物支出估计为680亿美元。
美国成年人中高血压的存在与全因药物支出的增加相关,这种增加在不同年龄和性别的群体中有所不同。