| アブストラクト | BACKGROUND: Delayed initiation of antihypertensive therapy after the initial identification of hypertension during health checkups has been linked to an increased risk of cardiovascular disease. 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-April 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 (<1 year) versus delayed (>/=1 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 yen5 million per QALY. RESULTS: In adults in their 40 s, early initiation yielded 13.52 QALYs and lifetime costs of yen3,991,757, compared with 12.85 QALYs and yen3,976,709 with delayed initiation, resulting in an incremental cost-effectiveness ratio of yen22,489 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. |
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| ジャーナル名 | Hypertension research : official journal of the Japanese Society of Hypertension |
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| Pubmed追加日 | 2026/8/20 |
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| 投稿者 | Ito, Hiromasa; Seki, Tomohisa; Takiguchi, Toru; Akagi, Yu; Kubota, Kazumi; Miyake, Kana; Okada, Masafumi; Ohe, Kazuhiko; Kawazoe, Yoshimasa |
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| 組織名 | Department of Cardiology and Nephrology, Mie University Graduate School of;Medicine, Mie, Japan. h-ito@med.mie-u.ac.jp.;Department of Healthcare Information Management, The University of Tokyo;Hospital, Tokyo, Japan. h-ito@med.mie-u.ac.jp.;Hospital, Tokyo, Japan.;Department of Applied Health Informatics, Graduate School of Medicine, Dentistry;and Pharmaceutical Sciences, Okayama University, Okayama, Japan.;Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo,;Japan.;Department of Biomedical Informatics, Graduate School of Medicine, The University;of Tokyo, Tokyo, Japan.;Artificial Intelligence and Digital Twin in Healthcare, Graduate School of;Medicine, The University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42618627/ |
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