Working Paper: NBER ID: w12096
Authors: Genia Long; David Cutler; Ernst R. Berndt; Jimmy Royer; Andreanne Fournier; Alicia Sasser; Pierre Cremieux
Abstract: Estimating the value of medical innovation is a continual challenge. In this research, we quantify the impact of antihypertensive therapy on U.S. blood pressures, risk and number of heart attacks, strokes, and deaths. We also consider the potential for further improvements. We estimate the value of innovation using equations relating blood pressure to adverse outcomes from the Framingham Heart Study. Our results show that without antihypertensive therapy, 1999-2000 average blood pressure for the U.S. population age 40 plus would have been 10-13 percent higher. 86,000 excess premature deaths from cardiovascular disease (2001), and 833,000 hospital discharges for stroke and heart attacks (2002) would have occurred. Life expectancy would be 0.5 (men) and 0.4 (women) years lower. At guideline care, there would have been 89,000 fewer premature deaths (2001) and 420,000 fewer hospital discharges for stroke and heart attack (2002) than observed. Our analysis suggests that antihypertensive therapy has had a significant impact on cardiovascular health outcomes but that mortality gains would have been approximately twice as high if guideline care had been achieved for all.
Keywords: antihypertensive therapy; cardiovascular disease; public health
JEL Codes: I1; O3
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Antihypertensive therapy (L42) | Reduction in average blood pressure for the US population aged 40 and over (I14) |
| Reduction in average blood pressure for the US population aged 40 and over (I14) | Reduction in excess premature deaths from cardiovascular disease (I14) |
| Antihypertensive therapy (L42) | Reduction in hospital discharges related to stroke and heart attacks (I12) |
| Guideline care could have prevented additional premature deaths (I12) | Impact of achieving optimal treatment standards (I14) |
| Guideline care could have prevented additional hospital discharges (I10) | Impact of achieving optimal treatment standards (I14) |
| Antihypertensive therapy (L42) | Improvement in life expectancy (I14) |