{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T22:26:14Z","timestamp":1788819974830,"version":"build-2803163510"},"reference-count":92,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers\n for Disease Control and Prevention","doi-asserted-by":"publisher","award":["1NU2HGH000044-01-00"],"award-info":[{"award-number":["1NU2HGH000044-01-00"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,17]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"\n Objective<\/jats:title>\n Estimate the incremental costs and benefits of scaling up\n hypertension care in adults in 24 select countries, using three\n different systolic blood pressure (SBP) treatment cut-off points\u2014\u2265140,\n \u2265150 and \u2265160\u2009mm Hg.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Strengthening the hypertension care cascade compared with status quo\n levels, with pharmacological treatment administered at different\n cut-points depending on the scenario.<\/jats:p>\n <\/jats:sec>\n \n Target population<\/jats:title>\n Adults aged 30+ in 24 low-income and middle-income countries\n spanning all world regions.<\/jats:p>\n <\/jats:sec>\n \n Perspective<\/jats:title>\n Societal.<\/jats:p>\n <\/jats:sec>\n \n Time horizon<\/jats:title>\n 30 years.<\/jats:p>\n <\/jats:sec>\n \n Discount rate<\/jats:title>\n 4%.<\/jats:p>\n <\/jats:sec>\n \n Costing year<\/jats:title>\n 2020 USD.<\/jats:p>\n <\/jats:sec>\n \n Study design<\/jats:title>\n <\/jats:sec>\n \n Data sources<\/jats:title>\n Institute for Health Metrics and Evaluation\u2019s Epi Visualisations\n database\u2014country-specific cardiovascular disease (CVD) incidence,\n prevalence and death rates. Mean SBP and prevalence\u2014National surveys and\n NCD-RisC. Treatment protocols\u2014WHO HEARTS. Treatment impact\u2014academic\n literature. Costs\u2014national and international databases.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n Health outcomes\u2014averted stroke and myocardial infarction events,\n deaths and disability-adjusted life-years; economic outcomes\u2014averted\n health expenditures, value of averted mortality and workplace\n productivity losses.<\/jats:p>\n <\/jats:sec>\n \n Results of analysis<\/jats:title>\n Across 24 countries, over 30 years, incremental scale-up of\n hypertension care for adults with SBP\u2265140\u2009mm Hg led to 2.6\u2009million\n averted CVD events and 1.2\u2009million averted deaths (7% of expected CVD\n deaths). 68% of benefits resulted from treating those with very high SBP\n (\u2265160\u2009mm Hg). 10 of the 12 highest-income countries projected positive\n net benefits at one or more treatment cut-points, compared with 3 of the\n 12 lowest-income countries. Treating hypertension at SBP\u2265160\u2009mm Hg\n maximised the net economic benefit in the lowest-income\n countries.<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n The model only included a few hypertension-attributable diseases and\n did not account for comorbid risk factors. Modelled scenarios assumed\n ambitious progress on strengthening the care cascade.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In areas where economic considerations might play an outsized role,\n such as very low-income countries, prioritising treatment to populations\n with severe hypertension can maximise benefits net of economic\n costs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-071036","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T19:40:27Z","timestamp":1715283627000},"page":"e071036","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Scaling hypertension treatment in 24 low-income and middle-income\n countries: economic evaluation of treatment decisions at three blood\n pressure cut-points"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-5351","authenticated-orcid":false,"given":"Brian","family":"Hutchinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5907-2784","authenticated-orcid":false,"given":"Adam","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1093-4742","authenticated-orcid":false,"given":"Norm","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2225-383X","authenticated-orcid":false,"given":"Paul K","family":"Whelton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-0451","authenticated-orcid":false,"given":"Cherian","family":"Varghese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6049-0505","authenticated-orcid":false,"given":"Muhammad Jami","family":"Husain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6421-9077","authenticated-orcid":false,"given":"Rachel","family":"Nugent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2414-0166","authenticated-orcid":false,"given":"Deliana","family":"Kostova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0166-1399","authenticated-orcid":false,"given":"Amanda","family":"Honeycutt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"2024050912273639000_14.4.e071036.1","unstructured":"Global Burden of Disease Collaborative Network .\n Global Burden of Disease Study 2019 (GBD 2019) results. 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