Evidence map›Paper›PMID 39482792›Full record

ArticleClinical hypertension2024

Cost-effectiveness of strengthening blood pressure classification in South Korea: comparing the 2017 ACC/AHA and KSH guidelines.

KyungYi Kim, Min Ji Hong, Bomgyeol Kim, Hae-Young Lee, Tae Hyun Kim

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In one paragraph

Article in Clinical hypertension, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

KyungYi KimDepartment of Healthcare Management, Graduate School of Public Health, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.ORCID http://orcid.org/0000-0002-7856-3255
Min Ji HongDepartment of Medical Device Engineering and Management, Yonsei University Graduate School, Seoul, Republic of Korea.ORCID http://orcid.org/0009-0009-7506-3165
Bomgyeol KimDepartment of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.ORCID http://orcid.org/0000-0002-3670-4988
Hae-Young LeeDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID http://orcid.org/0000-0002-9521-4102
Tae Hyun KimDepartment of Healthcare Management, Graduate School of Public Health, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. THKIM@yuhs.ac.ORCID http://orcid.org/0000-0003-1053-8958

Funding

Korean Society of Hypertension KSH-R-2022-03
6 · The paper itself

Abstract

backgroundHypertension is a significant risk factor for cardiovascular disease (CVD), with hypertension-related deaths increasing annually. While South Korea uses the Korean Society of Hypertension (KSH) guideline of 140/90 mmHg, the American College of Cardiology (ACC) and American Heart Association (AHA) updated their guidelines in 2017 to 130/80 mmHg. This study evaluates the cost-effectiveness of transitioning to the 2017 ACC/AHA guidelines by estimating early treatment impacts and potential CVD risk reduction.

methodsA Markov state-transition simulation model with a 10-year horizon was used to estimate cost-effectiveness, focusing on strengthening target blood pressure. Quality-adjusted life years (QALYs) served as the measure of effectiveness. Cohorts of 10,000 individuals representing South Koreans in their 20s through 80s were compared in scenario analyses from the healthcare system perspective. A 4.5% annual discount rate was applied to costs and effectiveness. Primary outcomes were incremental cost-effectiveness ratio (ICER) and net monetary benefit (NMB). The willingness-to-pay (WTP) threshold was < KRW 30,000,000/QALY gained. Probabilistic sensitivity analyses (PSAs) addressed model input parameter uncertainties.

resultsThe base-case analysis showed an ICER value of KRW 1,328,395/QALY gained across all populations. ICER values increased with age, from - KRW 3,138,071/QALY for 20-year-olds to KRW 16,613,013/QALY for individuals over 80. The 60s age group showed the greatest benefit with an incremental QALY gain of 0.46. All scenarios had ICERs below the WTP threshold, with a PSA probability of 98.0% that strengthening blood pressure classification could be cost-effective.

conclusionsThis economic evaluation found that adopting the 2017 ACC/AHA guidelines may result in early treatment, reduce the potential incidence of CVD events, and be cost-effective across all age groups. The study findings have implications for policymakers deciding whether and when to revise official guidelines regarding target blood pressure levels, considering the impacts on public health and budgetary concerns.

Indexed as

Blood pressureCardiovascular diseasesCost-effectiveness analysisEconomic evaluationHypertensionKidney failure, chronic

Identifiers

PMID39482792
PMCPMC11528990

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.