Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have investigated 1,051 treated hypertensives of both sexes in the Dalby primary health care (PHC) district, Sweden, to evaluate the organisation and the total cost of treatment. Male hypertensives (n = 486) made 1.78 physician visits annually and had a mean on-treatment BP of 160/91 mmHg. Correspondingly, female hypertensives (n = 565) made 1.67 visits and had a mean attained BP of 164/91 mmHg. The drug profile was dominated by the use of beta-receptor-blockers in 38% of all patients but the newer antihypertensive drugs (calcium antagonists, ACE inhibitors) were also commonly used. The total cost of treatment (drugs, consultations, time and travel expenses) was calculated to 2,680 SEK/patient/year, which is similar to that found in a previous study from another PHC district in Sweden, 2,660 SEK/drug-treated patient/year (after adjustment for increasing consumer price index, +29%, between the years of the studies, 1988-91). In conclusion, the hypertensives in Dalby were fairly well controlled according to BP levels. The treatment cost was higher than that of other PHC areas, which should be the focus of further analyses of cost-effectiveness.
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PMID:Care of hypertensives in Dalby: organisation and health economic aspects. 811 45

A switch from treatment with diuretics and beta-blockers to treatment with the more expensive ACE-inhibitors and calcium-antagonists has been noted in the hypertension field. The aim of this paper was to analyse the cost-effectiveness of this switch towards more expensive antihypertensive drugs in Sweden. The upper limit of the cost-effectiveness of ACE-inhibitors and calcium-antagonists compared with diuretics and beta-blockers was estimated by assuming that ACE-inhibitors and calcium-antagonists achieve the epidemiologically expected risk reduction for coronary heart disease. The incremental cost per life-year gained varies between approximately SEK 50,000 and approximately SEK 6,000,000 ($1 = SEK 6) in the different patient groups analysed. It is concluded that ACE-inhibitors and calcium-antagonists may be potentially cost-effective in some patient groups at a high risk of coronary heart disease. Since an improved risk reduction has not been demonstrated in clinical trials, however, ACE-inhibitors and calcium-antagonists cannot at present be recommended for hypertension treatment in any patient groups unless treatment with diuretics and beta-blockers is contraindicated.
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PMID:The cost-effectiveness of the switch towards more expensive antihypertensive drugs. 1013 3