The cost-effectiveness of treating hypertension in elderly people--an analysis of the Swedish Trial in Old Patients with Hypertension (STOP Hypertension).

OBJECTIVES

The aim of this study was to estimate the cost-effectiveness of antihypertensive treatment in elderly people based on the results of the Swedish Trial in Old Patients with Hypertension (STOP Hypertension).

DESIGN

The STOP Hypertension study was a randomized trial comparing active antihypertensive treatment with a placebo. The risk of stroke, cardiovascular disease and total mortality was significantly reduced in the actively treated group compared to placebo.

SETTING

One hundred and sixteen primary health care centres in Sweden.

SUBJECTS

A total of 1627 hypertensive patients aged 70-84. No patient was lost to follow-up.

INTERVENTIONS

Antihypertensive treatment with beta blockers and diuretics for a mean follow-up of 25 months.

MAIN OUTCOME MEASURE

The cost-effectiveness ratio estimated as the net cost (the treatment cost minus saved costs of reduced cardiovascular morbidity) divided by the number of life-years gained (the increase in life expectancy from treatment).

RESULTS

The cost per life-year gained was estimated as SEK 5000 for men and SEK 15,000 for women ($1 = SEK 6; 1 pound = SEK 10). The cost per life-year gained did not exceed SEK 100,000 in any of the sensitivity analyses.

CONCLUSIONS

It is concluded that treatment of elderly hypertensive patients with beta blockers and/or diuretics is cost-effective according to the results of the STOP Hypertension study.