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 of managed care patients in New Mexico from January 1, 1996, to December 31, 1997. Patients and methods: We stratified 1000 hypertensive patients into categories based on average and maximum BP. Antihypertensive medication use and cost, number of physician visits, and interval between hypertension-related physician visits were determined. Results: Medication costs increased progressively across all BP categories from lowest to highest, and higher average systolic BP (SBP) was significantly correlated with increased cost (P < .001). There were significant correlations between higher maximum BP and greater number of hypertension-related physician visits (P < .001). Mean number of visits for BP groups was 5.5 for patients with a maximum diastolic BP (DBP) <85 mm Hg and 10.0 for those with a maximum DBP ≥100 mm Hg (P < .001). Patients with a maximum SBP ≥ 180 mm Hg averaged 9.7 visits, whereas those with a maximum SBP <120 mm Hg averaged 4.1 visits (P < .001). Both SBP and DBP were significantly correlated with time to next visit (P < .001). Mean visit intervals ranged from 44 days for patients with an SBP <85 mm Hg to 25 days for those with an SBP ≥180 mm Hg (P < .001). A similar association was found between DBP and visit interval. Conclusions: Poor control of hypertension is associated with higher drug costs and more physician visits. Aggressive treatment might help reduce managed care costs and resource utilization.