Impact of poorly controlled hypertension on healthcare resource utilization and cost

Objective: To examine the relation between blood pressure (BP) control and utilization and cost of healthcare resources. Study Design: A retrospective database study oi managed care patients in Ne w Mexico from January 1, 1996, to December 31, 1997. Patients and Methods: We stratified 1000 hypertensive patients into categor ies based on average and maximum BP. Antihypertensive medication use and co st, number oi physician visits, and interval between hypertension-related p hysician visits were determined. Results: Medication costs increased progressively across all BP categories from lowest to highest, and higher average systolic BP (SBP) was significan tly correlated with increased cost (P < .001). There were significant corre lations between higher maximum BP and greater number oi hypertension-relate d physician visits (P < .001). Mean number oi visits Tor BP groups was 5.5 for patients with a maximum diastolic BP (DBP) < 85 mm Hg and 10.0 for thos e with a maximum DBP <greater than or equal to> 100 mm Hg (P < .001). Patie nts with a maximum SBP <greater than or equal to> 180 mm Hg averaged 9.7 vi sits, whereas those with a maximum SEP < 120 mm Hg averaged 4.1 visits (P < .001). Both SEP and DBP were significantly correlated with time to next vi sit (P < .001). Mean visit intervals ranged from 44 days for patients with an SEP < 85 mm Hg to 25 days for those with an SEP greater than or equal to 180 mm Hg (P < .001). A similar asso ciation was found between DBP and vis it interval. Conclusions: Poor control oi hypertension is associated with higher drug co sts and more physician visits. Aggressive treatment might help reduce manag ed care costs and resource utilization.