Clinical Drug Investigation

, Volume 28, Issue 4, pp 211–220 | Cite as

Economic Benefits of Treating High-Risk Hypertension with Angiotensin II Receptor Antagonists (Blockers)

Review Article

Abstract

Hypertension is one of the leading risk factors for cardiovascular disease and represents a major health and economic burden. Most patients with high-or very high-risk hypertension have multiple cardiovascular risk factors with or without accompanying subclinical organ damage or established cardiovascular or renal disease. Patients with severe hypertension or with moderate hypertension and one to two additional risk factors have absolute 10-year risks of cardiovascular disease of 21–30% and 15–20%, respectively. Current European treatment guidelines recommend that antihypertensive therapy be initiated rapidly and aggressively in patients with high-risk hypertension. Most patients require two or more antihypertensive agents to achieve the strict blood pressure target of <130/80 mmHg. This article reviews the existing cost-effectiveness data on the use of angiotensin II receptor antagonists (blockers) [ARBs] in patients with high-risk hypertension. Aggressive ARB treatment of patients in the early (microalbuminuric) stages of diabetic nephropathy has a significant renoprotective effect, delaying the onset of overt (proteinuric) nephropathy. By slowing the progression of these patients to end-stage renal disease, substantial cost savings can be made. There is a paucity of cost-effectiveness data regarding the use of fixed-dose ARB plus thiazide diuretic combination therapies. Longitudinal cost-benefit studies of this attractive and efficacious first-line treatment option are needed.

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© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.Department of Internal Medicine, Institute of Medicine and Dermatology, Hypertension Unit, Hospital ClínicoUniversity of BarcelonaBarcelonaSpain

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