The cost-effectiveness of hypertension treatment in Sweden: An analysis of the criteria for intervention and the choice of drug treatment

Results of an analysis of the cost-effectiveness of hypertension treatment in Sweden are presented. The cost per life-year gained decreases with age for both men and women and is relatively low for middle-aged and older men and women even in the blood pressure range 90-94 mmHg. The results indicate that it is in general cost-effective to treat middle-aged and older men and women in Sweden with a diastolic blood pressure greater than or equal to 90 mmHg, but that it is questionable whether it is in general cost-effective to treat younger men and women with mild hypertension. It is furthermore shown that ACE-inhibitors and calcium-antagonists may be cost-effective in some patient groups at a high risk of coronary heart disease, if they achieve the epidemiologically expected risk reduction for coronary heart disease. Since an improved risk reduction has not been demonstrated in clinical trials ACE-inhibitors and calcium-antagonists cannot, however, at present be recommended for hypertension treatment in any patient groups unless treatment with diuretics and beta-blockers is contraindicated.