Abstract
BackgroundThis retrospective cohort study examined the sex- and age-specific impact of hypertension on medical expenditures.MethodsIn 2006, we analyzed the medical expenditure records of 42 426 Japanese National Health Insurance beneficiaries (16 169 men, 26 257 women) who lived in Ibaraki, Japan, were aged 40 to 69 years, and underwent health checkups in 2002. Blood pressure was classified into 4 categories according to the criteria outlined in the seventh report of the Joint National Committee.ResultsThe difference in median total expenditure between the hypertension categories and the normotension category was 119 585 yen (140 360 yen vs 20 775 yen) for men aged 40 to 54 years, 126 160 yen (204 070 yen vs 77 910 yen) for men aged 55 to 69 years, 125 495 yen (158 025 yen vs 32 530 yen) for women aged 40 to 54 years, and 122 370 yen (208 700 yen vs 86 330 yen) for women aged 55 to 69 years. The median total and outpatient medical expenditures markedly differed between patients with stage 1 hypertension and stage 2 hypertension (which included people on antihypertensive medication) in both sexes and all age subgroups. The median total and outpatient medical expenditures were higher among women than among men in all blood pressure categories.ConclusionsThe impact of hypertension on medical expenditures was similar in all age groups. Therefore, from the perspective of medical economics, prevention of the onset of hypertension seems equally important for all age subgroups.
Highlights
Hypertension is a powerful risk factor for stroke, coronary disease, cardiac failure, and peripheral artery disease[1]; it is related to higher health care expenditures.[2,3,4] In Japan, the impact of hypertension on medical care expenditure has been seen among beneficiaries of health insurance plans managed by the government[3] and the National Health Insurance system.[4]
The results of this large retrospective cohort study showed that the impact of hypertension on medical expenditure was similar across age groups among beneficiaries of the National Health Insurance system in Japan
The median total and outpatient medical expenditures were markedly different between subjects with stage 1 hypertension and stage 2 hypertension among both sexes and all age subgroups
Summary
Hypertension is a powerful risk factor for stroke, coronary disease, cardiac failure, and peripheral artery disease[1]; it is related to higher health care expenditures.[2,3,4] In Japan, the impact of hypertension on medical care expenditure has been seen among beneficiaries of health insurance plans managed by the government[3] and the National Health Insurance system.[4]. The associations of systolic blood pressure with all-cause mortality and the incidence of and mortality from cardiovascular disease have been reported to be age-dependent among whites,[7,8,9] residents of the entire Asia-Pacific region,[10] and Japanese,[11] which suggests that the impact of hypertension on medical expenditure may be age-dependent, in a manner similar to the relationship between hypertension and mortality. From the perspective of medical economics, prevention of the onset of hypertension seems important for all age subgroups
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