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2011英国高血压指南(3)

来源:网络收集 时间:2026-06-29
导读: Evidencestatementsinthissummaryrelatetotheguidelineupdate.QualityratingswerebasedonGRADEmethodology().Theserelatetothequalityoftheavailableevidenceforassessedoutcomesratherthanthequalityoftheclinical

Evidencestatementsinthissummaryrelatetotheguidelineupdate.QualityratingswerebasedonGRADEmethodology().Theserelatetothequalityoftheavailableevidenceforassessedoutcomesratherthanthequalityoftheclinicalstudy.Outcomesassessedincludedmortality,heartfailure,newonsetdiabetesmellitus,vascularprocedures,angina,healthrelatedqualityoflife,andbloodpressureresponsetotreatment.Costeffectivenessanalysisformethodofdiagnosis

Aneconomicmodelwasdevelopedtocomparethecosteffectivenessofthreedifferentoptionsforbloodpressuremeasurementfordiagnosinghypertension:clinic,home,andambulatorybloodpressuremonitoring.Ambulatorybloodpressuremonitoringwasthemostcosteffectivestrategyformenandwomenofallages.Itwascostsavingforallagesconsideredforbothmenandwomenandresultedinmorequalityadjustedlifeyears(QALYs)formaleandfemaleagegroupsover50.Thisresultwasrobusttoawiderangeofsensitivityanalysesaroundthebasecasebutwassensitiveifhomemonitoringwasconsideredtohaveequaltestperformancetoambulatorymonitoringoriftreatmentwasconsideredeffectiveinindividualswhowerenothypertensive.Costeffectivenessanalysisforfirstlinedrugtreatment

Theeconomicmodelassessingfirstlinedrugtreatmentdevelopedaspartoftheclinicalguideline344wasupdated.Thiscomparednointervention,ACEinhibitororARB,βblockers,calciumchannelblockers,andthiazide-typediureticsintermsoflifetimecostsandqualityadjustedlifeyears(QALYs)fromaUKhealthserviceperspective.DrugcostswerebasedongenericUKlistprices.Treatinghypertensionwashighlycosteffective,resultinginimprovedhealthoutcomes(moreQALYs)andcostsavingswithalldrugclassescomparedwithnotreatment.Calciumchannelblockerswereshowntobethemostcosteffectiveintervention,withanincrementalcosteffectivenessratioofunder£2000(

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