Abstract 20369: Direct Medical Expenditures and Healthcare Utilization Associated With Resistant Hypertension in the United States
Background: Resistant hypertension (HTN) is associated with an increased risk of major adverse outcomes, but whether greater healthcare expenditures and utilization are linked to this condition has not been established.
Methods: Using pooled data (2003-2010) from the nationally-representative U.S. Medical Expenditure Panel Survey (MEPS), we compared direct healthcare expenditures and utilization between U.S. adults with aTRH (≥2 unique fills for ≥4 antihypertensive classes in a MEPS panel) and non-resistant hypertension (all other adults with HTN).
Results: Of 43,476 persons with HTN, 1924 (4.3%) met criteria for aTRH. Unadjusted mean total annual healthcare expenditures were greater for persons with aTRH ($20,018) compared to non-resistant HTN ($9,814; p<0.0001). In multivariable-adjusted analyses, aTRH was associated with $3,647 (95% CI $2,820-$4,475) excess total annual healthcare expenditures, $2,413 (95% CI $1,613-$3,212) excess annual medical expenditures, and $1,253 (95% CI $1,065-$1,441) excess total prescription expenditures, per person, relative to non-resistant HTN. Healthcare utilization rates were significantly greater for those with aTRH compared to non-resistant HTN (Table).
Conclusions: Apparent treatment-resistant HTN is associated with substantially greater direct healthcare expenditures and utilization compared with non-resistant HTN. Assuming a conservative prevalence of aTRH (5% of all U.S. adults with HTN), our results suggest that aTRH is associated with $11.3-17.9 billion per year in incremental medical expenditures relative to non-resistant HTN, in the U.S.
Author Disclosures: S.M. Smith: None. V. Ghushchyan: None. A. Libby: None.
- © 2014 by American Heart Association, Inc.