The acute problem of not focusing on chronic care

  • by: |
  • 03/26/2006

Here’s an exciting timely and important new paper on what antihypertensives have accomplished and what more could be accomplished if people were treated to guideline. It’s a clarion call to address our nation’s (indeed the globe’s) chronic health care problem — ignoring the urgency of focusing on chronic care.

The Impact of Antihypertensive Drugs on the Number and Risk of Death,
Stroke and Myocardial Infarction in the United States by Genia Long,
David Cutler, Ernst R. Berndt, Jimmy Royer, Andree-Anne Fournier, Alicia
Sasser, Pierre Cremieux #12096 (AG HC)

Abstract:

Estimating the value of medical innovation is a continual challenge.

In this research, we quantify the impact of antihypertensive therapy on U.S. blood pressures, risk and number of heart attacks, strokes, and deaths. We also consider the potential for further improvements.

We estimate the value of innovation using equations relating blood pressure to adverse outcomes from the Framingham Heart Study. Our results show that without antihypertensive therapy, 1999-2000 average blood pressure for the U.S. population age 40 plus would have been 10-13 percent higher. 86,000 excess premature deaths from cardiovascular disease (2001), and 833,000 hospital discharges for stroke and heart attacks (2002) would have occurred. Life expectancy would be 0.5 (men) and 0.4 (women) years lower. At guideline care, there would have been 89,000 fewer premature deaths (2001) and 420,000 fewer hospital discharges for stroke and heart attack (2002) than observed. Our analysis suggests that antihypertensive therapy has had a significant impact on cardiovascular health outcomes but that mortality gains would have been approximately twice as high if guideline care had been achieved for all.

Here’s the link:

http://papers.nber.org/papers/W12096

CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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