Disease management and pharmacoeconomics as tools for mass prevention of hypertensive complications

Hypertension has been identified as a major predictor of cardiovascular disease, which is a worldwide cause of morbidity and premature mortality. Optimal management of hypertension involves finding a balance among the benefits, risks, and costs of disease treatment and prevention of hypertensive sequelae. Cost-effectiveness analysis helps to clarify the trade-offs between the costs and benefits of treatment and also to evaluate the effects on quality of therapy. Disease management programs that incorporate pharmacoeconomic analysis and computerized methods of targeting patients at high risk of hypertensive sequelae are useful and cost-effective tools. Critical to these cost-effectiveness analyses and disease management programs are the expected benefits attributable to blood pressure reduction. The utility of these programs in helping to determine which patients will benefit from intensive intervention depends to a great extent on the assumptions made and the quality of the data used for the analyses - that is, the degree to which the data are evidence based.