Years Of Intensive Control Research Articles

PCV10 Cost-Effectiveness of Intensive VS. Moderate Hypertension Treatment in US Adults Age 65 and Older at High Risk of Atherosclerotic Cardiovascular Disease

Many hypertension management guidelines are available from different organizations, with no consensus on whether an intensive or moderate systolic blood pressure (SBP) management for high-risk adults aged ≥65 is better. This study aimed to assess the long-term economic value of intensive hypertension control compared with moderate control in the US elderly to guide the decision-making of hypertension treatment strategies. We developed a Markov model with a one-year time cycle to simulate the progression of stroke, coronary heart disease, and mortality over a lifetime window. We used the 2017 National Center for Health Statistics data to generate a national representative simulation sample of older adults aged ≥65. We extracted costs from the Healthcare Cost and Utilization Project Statistical Briefs and recent publications. We defined having SBP <130 mmHg as SBP control, and SBP <140 mmHg as moderate SBP control. Sensitivity analyses were conducted to assess how uncertainties of key model parameters influenced the simulation results. An incremental cost-effectiveness ratios (ICER) of ≤$50,000 per quality-adjusted life years (QALY) gained was considered as cost-effective. The mean survival time of moderate and intensive SBP control were 7.80 (95% CI 7.71-7.89) and 9.63 (95% CI 9.52-9.74) years, respectively. The incremental costs, QALYs, and life years of intensive control compared with moderate SBP control were $7,399 (95% CI $7,076- $7,722), 0.88 (95% CI 0.76-1.00), and 1.83 (95% CI 1.58-2.08) years. Comparing with moderate SBP control, intensive SBP control was cost-effective, with an ICER of $8,405/QALY (95% CI $7,960-$8,924/QALY). Sensitivity analyses showed that low medication adherence and high medication cost had moderate and high negative impacts on the cost-effectiveness of intensive SBP control, respectively. Among adults aged ≥65, aiming for an intensive SBP goal of <130 mmHg is a cost-effective strategy.

Involvement of advanced glycation end-products in 'hyperglycemic memory'.

The series of reports by the DCCT Skin Collagen Ancillary Study Group are very interesting and informative. The hypothesis from these reports clearly indicates that AGEs are a strong candidate for the mechanism of the 'hyperglycemic memory.'

Mitigation of Double-Crested Cormorant Impacts on Lake Ontario: From Planning and Practice to Product Delivery

The New York State Department of Environmental Conservation initiated a Double-crested Cormorant (Phalacrocorax auritus) control program in the eastern basin of Lake Ontario to mitigate cormorant impacts in 1999. Key objectives included improving the quality of Smallmouth Bass (Micropterus dolomieu) and other fisheries, restoring the structure and function of the warmwater fish community and reducing cormorant impacts to nesting habitats of other colonial waterbird species. In eight years of intensive control, cormorant numbers declined, with a corresponding reduction in estimated fish consumption. Diversity and numbers of co-occurring waterbirds either increased or have not been shown to be negatively impacted by management. Woody vegetation favorable to Black-crowned Night-Herons (Nycticorax nycticorax) has been maintained. A ca. 2.5-fold increase in the abundance of Smallmouth Bass abundance in assessment nets over the last seven years is a sign of improved recruitment to the fishery. Since the target population level of 4,500 to 6,000 cormorants has essentially been achieved, the eastern Lake Ontario cormorant program is expected to shift in 2007 from a population reduction focus towards a less intensive program intended to prevent population resurgence.