Incremental expenditure of treating hypertension in the United States

Background: This study determined incremental direct expenditures of treating hypertension in the United States population. Methods: Analysis of the 2001 Medical Expenditure Panel Survey (MEPS), a national probability sample survey of the civilian noninstitutionalized U.S. population, was conducted. Hypertensive patients were identified as those with a medical diagnosis for hypertension based on International Classification of Diseases (ICD)-9 codes; patients who were consumers of hypertension-related medical care services including inpatient and outpatient visits, emergency room visits, home health visits, office-based medical provider visits, and other medical expenses; patients who self-reported being diagnosed with hypertension by their physicians; and patients who were prescribed antihypertensive medication. Incremental expenditure of treating hypertension was estimated through least-squares regression adjusting for age, sex, ethnicity, education, and comorbidities using the D'Hoore et al version of the Charlson comorbidity index. Sample data were projected to the U.S. population and 95% confidence limits for estimates were calculated using the Taylor expansion method. Results: Sample estimates projected to the population indicated that approximately 17.4% of individuals >= 18 years of age in the ambulatory population have hypertension. Total incremental annual direct expenditures for hypertension patients were estimated to be more than $US 54.0 billion in 2001 after adjusting for demographics and comorbidities. Mean incremental annual direct expenditures for an individual with hypertension was $US 1,131. Prescription medicines, inpatient visits, and outpatient visits constituted > 90% of overall incremental expenditures. Conclusions: With incremental direct medical expenditures estimated at nearly $US 55.0 billion, hypertension expenditures represent a significant amount of health care resource use.