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However, the long-term economic implications of this practice are not well understood. This study aimed to analyze the cost-effectiveness of early antihypertensive treatment. Methods: A Markov cohort model with four health states (baseline hypertension, acute cardiovascular disease (CVD), post-CVD, and death) was developed to project long-term outcomes for adults with screening-detected hypertension using data from the Japan Medical Data Center database, recorded January 2005\u2013April 2021. Age-specific transition probabilities, CVD-related costs, and mortality were derived from a previously published cohort. Quality-adjusted life-years (QALYs) were estimated using utility values from prior literature. Early (&lt;1 year) versus delayed (\u22651 year) treatment initiation were compared across four age groups over a 20-year horizon from the healthcare payer perspective, applying a 2% annual discount rate. Deterministic and probabilistic sensitivity analyses assessed parameter uncertainty, and cost-effectiveness was evaluated against a willingness-to-pay threshold of \u00a55 million per QALY. Results: In adults in their 40\u2009s, early initiation yielded 13.52 QALYs and lifetime costs of \u00a53,991,757, compared with 12.85 QALYs and \u00a53,976,709 with delayed initiation, resulting in an incremental cost-effectiveness ratio of \u00a522,489 per QALY. Early initiation remained highly cost-effective across all age groups, and probabilistic analyses demonstrated a high likelihood of cost-effectiveness. Conclusions: These findings support encouraging healthcare payers to use screening results proactively to promote early hypertension management and strengthen follow-up systems that reduce delays between detection and appropriate treatment.<\/jats:p>","DOI":"10.1038\/s41440-026-02776-5","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T03:34:09Z","timestamp":1787110449000},"page":"2655-2665","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness analysis of early antihypertensive treatment for hypertension detected at health screening"],"prefix":"10.1038","volume":"49","author":[{"given":"Hiromasa","family":"Ito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Takiguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Akagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumi","family":"Kubota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Ohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Kawazoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"2776_CR1","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1016\/j.jacc.2023.11.007","volume":"82","author":"GA Mensah","year":"2023","unstructured":"Mensah GA, Fuster V, Murray CJL, Roth GA. 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