Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study
Objective: Blood pressure reduction alone is insufficient for significant cardiovascular risk improvement in patients with hypertension. Cardiovascular risk assessment and management are recommended to prevent and control cardiovascular diseases (CVD), but their cost-effectiveness in real-world Chin...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | American Journal of Preventive Cardiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667725000820 |
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| author | Siqi Lin Liming Lin Wenyao Peng Xuan Liu Xi Li Jiapeng Lu Shouling Wu |
| author_facet | Siqi Lin Liming Lin Wenyao Peng Xuan Liu Xi Li Jiapeng Lu Shouling Wu |
| author_sort | Siqi Lin |
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| description | Objective: Blood pressure reduction alone is insufficient for significant cardiovascular risk improvement in patients with hypertension. Cardiovascular risk assessment and management are recommended to prevent and control cardiovascular diseases (CVD), but their cost-effectiveness in real-world Chinese settings is unclear. This study evaluated the benefits and cost-effectiveness of two strategies based on cardiovascular risk in Chinese hypertensive patients aged ≥35 years: statin treatment and lifestyle management + statin treatment. Methods: A decision-analytic Markov cohort model was constructed to estimate health benefits and incremental cost-effectiveness ratios between two interventions and no intervention over 10-year and lifetime horizons. Parameters including stroke/myocardial infarction (MI) incidence, all-cause mortality, costs, and health utilities were extracted from the Kailuan study, published literature, or public datasets. Sensitivity analyses assessed the influence of parameter uncertainty on the results of base-case analysis. Results: Statin treatment alone in hypertensive patients with high cardiovascular risk was projected to avert 847,350 stroke cases, 1412,250 MI cases and 564,900 all-cause deaths over a 10-year time horizon. Lifestyle management combined with statin treatment could prevent more cardiovascular and death events and was highly cost-effective ($1219.76/quality-adjusted life-year vs. gross domestic product per capita $12,680.83). Over a lifetime horizon, it was highly cost-effective regardless of the age when the combined intervention was started, with earlier initiation yielding greater benefits in preventing cardiovascular events. Sensitivity analyses confirmed robust results. Conclusion: Cardiovascular risk assessment and combined management in hypertensive individuals aged ≥35 years would generate substantial health gains and represent a highly cost-effective CVD prevention strategy in China. |
| format | Article |
| id | doaj-art-3d8ae154b2b0469e860a36f645dfcbac |
| institution | Kabale University |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-3d8ae154b2b0469e860a36f645dfcbac2025-08-20T03:53:47ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-06-012210100710.1016/j.ajpc.2025.101007Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling studySiqi Lin0Liming Lin1Wenyao Peng2Xuan Liu3Xi Li4Jiapeng Lu5Shouling Wu6National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR ChinaNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR ChinaNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China; Shenzhen Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong, China; Central China Sub-center of the National Center for Cardiovascular Diseases, Zhengzhou, Henan, ChinaNational Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China; Corresponding author at: National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, 167 Beilishi Road, Beijing 100037, PR China.Department of Cardiology, Kailuan General Hospital, Tangshan, China; Corresponding author at: Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Tangshan 063001, PR China.Objective: Blood pressure reduction alone is insufficient for significant cardiovascular risk improvement in patients with hypertension. Cardiovascular risk assessment and management are recommended to prevent and control cardiovascular diseases (CVD), but their cost-effectiveness in real-world Chinese settings is unclear. This study evaluated the benefits and cost-effectiveness of two strategies based on cardiovascular risk in Chinese hypertensive patients aged ≥35 years: statin treatment and lifestyle management + statin treatment. Methods: A decision-analytic Markov cohort model was constructed to estimate health benefits and incremental cost-effectiveness ratios between two interventions and no intervention over 10-year and lifetime horizons. Parameters including stroke/myocardial infarction (MI) incidence, all-cause mortality, costs, and health utilities were extracted from the Kailuan study, published literature, or public datasets. Sensitivity analyses assessed the influence of parameter uncertainty on the results of base-case analysis. Results: Statin treatment alone in hypertensive patients with high cardiovascular risk was projected to avert 847,350 stroke cases, 1412,250 MI cases and 564,900 all-cause deaths over a 10-year time horizon. Lifestyle management combined with statin treatment could prevent more cardiovascular and death events and was highly cost-effective ($1219.76/quality-adjusted life-year vs. gross domestic product per capita $12,680.83). Over a lifetime horizon, it was highly cost-effective regardless of the age when the combined intervention was started, with earlier initiation yielding greater benefits in preventing cardiovascular events. Sensitivity analyses confirmed robust results. Conclusion: Cardiovascular risk assessment and combined management in hypertensive individuals aged ≥35 years would generate substantial health gains and represent a highly cost-effective CVD prevention strategy in China.http://www.sciencedirect.com/science/article/pii/S2666667725000820HypertensionCardiovascular risk assessment and managementChineseCost-effectiveness analysisStatin treatment |
| spellingShingle | Siqi Lin Liming Lin Wenyao Peng Xuan Liu Xi Li Jiapeng Lu Shouling Wu Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study American Journal of Preventive Cardiology Hypertension Cardiovascular risk assessment and management Chinese Cost-effectiveness analysis Statin treatment |
| title | Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study |
| title_full | Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study |
| title_fullStr | Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study |
| title_full_unstemmed | Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study |
| title_short | Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study |
| title_sort | cost effectiveness of cardiovascular risk assessment and management among adults with hypertension in china a modelling study |
| topic | Hypertension Cardiovascular risk assessment and management Chinese Cost-effectiveness analysis Statin treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2666667725000820 |
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