Model Based Approach to Improving Hypertension Control in Populations

项目摘要 在美国，高血压是心血管疾病（CVD）的主要可预防风险因素。在 约有2800万成年人患有高血压，血压没有控制到推荐的治疗目标。 由于便宜，安全，有效的药物是可用的，不受控制的高血压是一个错过了 改善美国人民健康的机会。 为了这个项目，我们组建了一个由高血压、生物统计学、临床试验、健康经济学、 评估和计算机模拟建模，以评估实施两个 临床试验中研究的高血压控制方案类型：团队护理和家庭血压 监测.将使用已发表的和个人水平的临床试验和计算机模拟分析， 模型，在美国成人中 ·比较有效性（预防心血管事件和死亡的数量）和成本效益 不同的高血压控制方法，单独或联合，在所有美国成年人和年龄范围内， 类别、种族/民族和CVD风险类别 ·不同高血压控制方案的效果和成本-效果比较， 三个Medicare责任医疗机构（纽约）中未控制的高血压患者 Quality Care、Ochsner Accountable Care和Cedars-Sinai Accountable Care） ·实施120 mmHg收缩压目标的比较有效性和成本效益， 根据Syrup血压干预试验（SPRINT），年龄≥50岁的高风险美国成人 资格 相关性 这些分析的结果有可能提高常规高血压治疗的质量 临床实践，这可能会导致改善美国人口的心血管健康。

Project Summary Hypertension is the leading preventable risk factor for cardiovascular disease (CVD) in the United States. In about 28 million adults with hypertension, blood pressure is not controlled to recommended treatment goals. Because inexpensive, safe, and effective medications are available, uncontrolled hypertension is a missed opportunity to improve the health of the U.S. population. For this project, we assembled a team of experts in hypertension, biostatistics, clinical trials, health economic evaluation, and computer simulation modeling in order to evaluate the incremental value of implementing two types of hypertension control programs studied in clinical trials: team-based care and home blood pressure monitoring. Analyses of published and individual-level clinical trial and computer simulation will be used to model, in U.S. adults • The comparative effectiveness (number of prevented CVD events and deaths) and cost-effectiveness of different hypertension control approaches, alone or in combination, in all U.S. adults and within age categories, race/ethnic groups, and CVD risk categories • The comparative effectiveness and cost-effectiveness different hypertension control programs in patients with uncontrolled hypertension in three Medicare Accountable Care Organizations (New York Quality Care, Ochsner Accountable Care, and Cedars-Sinai Accountable Care) • The comparative effectiveness and cost-effectiveness of implementing a 120 mmHg systolic BP goal in high risk U.S. adults aged ≥50 years according to Systolic Blood Pressure Intervention Trial (SPRINT) eligibility Relevance The results of these analyses have the potential to improve the quality of hypertension treatment in routine clinical practice, which may lead to improved cardiovascular health in the U.S. population.