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 ran domized 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 SEK5000 for men and SEK15000 for women ($1 = SEK6; L1 = SEK10). The cost per life-year gained did not exceed SEK 100000 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.