Medical care expenditures for hypertension, its complications, and its comorbidities

OBJECTIVES. Medical expenditures attributed to hypertension were estimated, including expenditures for cardiovascular complications, other conditions for which hypertensives are at higher risk, and comorbidities (secondary di agnoses) that raise the cost of medical care. This article presents total, per capita, and per condition US expenditures in 1998 according to sex, age , and type of health service. METHODS. A variety of national data sources were used to disaggregate natio nal health expenditures in 1998 by diagnosis. Expenditures for cardiovascul ar complications and other conditions for which hypertensives had higher ra tes of utilization were determined by analysis of attributable risks. Addit ional expenditures generated by extra hospital inpatient days and higher ch arges for nursing home and home health care for comorbidities were estimate d by regression analyses. RESULTS. In 1998, $108.8 billion in health care spending was attributed to hypertension, 12.6% of total national spending that could be allocated to d iagnoses, including $22.8 billion for hypertension, $29.7 billion for cardi ovascular complications, and $56.4 billion for other diagnoses. Per capita expenditures increased with age from $249 for those younger than 65 years t o $3,007 for those 85 years and older. The average amount spent per hyperte nsive condition was $3,787. Expenditures were generally higher for females. CONCLUSIONS. The economic burden of hypertension is large, but health servi ces directly related to hypertension account for only a fraction of attribu ted expenditures. Comprehensive accounting of expenditures more accurately assesses the cost of hypertension and potential savings from prevention and treatment. Alteration of lifestyles and medical intervention provide oppor tunities to reduce national health expenditures.