Johannesson M, Dahlöf B, Lindholm L H, Ekbom T, Hansson L, Odén A, Scherstén B, Wester P O, Jönsson B
Centre for Health Economics, Stockholm School of Economics, Sweden.
J Intern Med. 1993 Sep;234(3):317-23. doi: 10.1111/j.1365-2796.1993.tb00749.x.
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).
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.
One hundred and sixteen primary health care centres in Sweden.
A total of 1627 hypertensive patients aged 70-84. No patient was lost to follow-up.
Antihypertensive treatment with beta blockers and diuretics for a mean follow-up of 25 months.
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).
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.
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.
本研究旨在根据瑞典老年高血压患者试验（STOP高血压）的结果，评估老年人降压治疗的成本效益。
STOP高血压研究是一项随机试验，比较了积极降压治疗与安慰剂治疗。与安慰剂相比，积极治疗组的中风、心血管疾病和总死亡率风险显著降低。
瑞典的116个初级卫生保健中心。
共有1627名年龄在70 - 84岁的高血压患者。无患者失访。
使用β受体阻滞剂和利尿剂进行降压治疗，平均随访25个月。
成本效益比，计算方法为净成本（治疗成本减去因心血管疾病发病率降低而节省的成本）除以获得的生命年数（治疗导致的预期寿命增加）。
男性每获得一个生命年的成本估计为5000瑞典克朗，女性为15000瑞典克朗（1美元 = 6瑞典克朗；1英镑 = 10瑞典克朗）。在任何敏感性分析中，每获得一个生命年的成本均未超过100,000瑞典克朗。
根据STOP高血压研究的结果，得出结论：用β受体阻滞剂和/或利尿剂治疗老年高血压患者具有成本效益。
