NEW THERAPEUTIC PARADIGMS AND CLINICAL-FINANCIAL MANAGEMENT OF HYPERTENSION. A NARRATIVE REVIEW
Abstract:
Hypertension (HT) is a major cardiovascular risk factor which has a major global burden
on society as revealed by the World Bank in 1990s. The disability adjusted life year (DALY) is an
indicator which quantifies mortality, morbidity and the burden associated with hypertension. All of
this data is highlighted in the context in which global public health is undergoing a paradigm shift,
through the transition from “evidence-based medicine” (EBM) to “value-based medicine” (VBM).
The advantages of interventions on HT are the reduction of the risk of cardiovascular disease, death
and disability rates, as well as the reduction of costs due to acute and chronic (preventable) HT
complications. At the cost of increasing the psychological burden and interference with the quality of
life, once the diagnosis of HT is established, a need to make lifestyle changes develops and the risk of
exposure to antihypertensive medication’s adverse effects ensues. At the same time, this diagnosis
increases the health system burden, with direct and indirect management costs, such as:
antihypertensive drugs, treatment adherence costs, HT-treatment resistant costs, informal costs
(informal care). There is a need for a formal integration of cost analysis when putting together HT
guidelines, while also considering factors such as opportunity cost, efficiency, benefits, and the costeffectiveness
incremental rapport
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