Higher Blood Pressure Correlates with Higher Healthcare Costs

Risk factors associated with age-related disease and mortality tend to also associate with higher medical costs. Obesity, for example, both shortens life span and increases lifetime medical costs thanks to the impact it has on health. High blood pressure, the condition known as hypertension, is another measure that reliably predicts a higher risk of mortality and poor health in later life. Here researchers run the numbers to show that it also results in higher medical costs, much as expected.

Hypertension isn't too far removed from the root causes of aging. High blood pressure is a direct result of arterial stiffening, as that detrimental change disrupts the finely tuned feedback mechanisms that balance blood pressure. Stiffening of blood vessels is caused by a mixed bag of mechanisms from the SENS rejuvenation research portfolio, such as cross-linking of the extracellular matrix in blood vessel walls, and the presence of senescent cells producing inflammation that both encourages calcification and disrupts the function of the smooth muscle responsible for dilation and contraction of blood vessels.

Raised blood pressure harms sensitive tissue structures such as those of the brain and the kidneys. It causes an increased rate of rupture of capillaries on a day to day basis, each destroying a tiny area of tissue. In later life it interacts with atherosclerosis, which weakens and narrows blood vessels with fatty plaques, to increase the risk of a fatal structural failure, a stroke or heart attack. More subtly, hypertension also causes the heart to reshape itself for the worse, the muscle growing larger and weaker, leading to heart failure. All of this is why methods of forcing lower blood pressure can be beneficial, even when they don't address the underlying root causes of hypertension, as is the case for all of the present approaches available in the clinic. In the future, we would expect to see far better outcomes for patients result from rejuvenation therapies that reverse the causes of blood vessel stiffening, thereby turning back hypertension.

Adults with high blood pressure face $1,920 higher healthcare costs each year compared to those without high blood pressure, according to new research. Based on the U.S. prevalence of hypertension, researchers estimate the national adjusted annual cost for the adult population with high blood pressure to be $131 billion higher compared to those without the disease. It is important to note that this twelve-year study was conducted using previous hypertension guidelines - which defined high blood pressure as 140/90 mm Hg or higher. In 2017, the American Heart Association and the American College of Cardiology lowered the definition of high blood pressure to 130/80 mm Hg or higher. "The new lower definition of high blood pressure will increase the number of adults in the hypertensive population. This may decrease the average cost of hypertension for individual patients while increasing the overall societal costs of hypertension."

Compared to patients without high blood pressure, those with high blood pressure had: 2.5 times the inpatient costs; almost double the outpatient costs; and nearly triple the prescription medication expenditures. "While the increased cost for patients with high blood pressure remained stable from 2003-2014, the rising prevalence of hypertension will become an increasingly large burden on the U.S. population for hypertension expenditures. The better we can learn to recognize high blood pressure, treat it and manage it, the better we'll be able to address these costs." National statistics from the 2017 hypertension guidelines estimate that 46 percent of U.S. adults - 103 million people - have high blood pressure, but only about half of those have their blood pressure controlled despite improvements in diagnosing, treating, and controlling hypertension.

Link: https://newsroom.heart.org/news/adults-with-high-blood-pressure-face-higher-healthcare-costs


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