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Q J Med 2004; 97: 87-93
© Association of Physicians 2004; all rights reserved.

Hypothetical economic analysis of screening for left ventricular hypertrophy in high-risk normotensive populations

M.D. Witham, J.I. Davies1, A. Dawson1, P.G. Davey1 and A.D. Struthers1

From the Section of Ageing and Health and 1Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, UK

Received 24 June 2003 and in revised form 4 November 2003

Background: Left ventricular hypertrophy (LVH) measured by echocardiography is a powerful independent marker of increased cardiovascular risk. The prevalence of echocardiographic LVH in patients with high cardiovascular risk appears to be high, even in patients currently considered normotensive.

Aim: To ascertain the likely costs of screening for and treating echocardiographic LVH in normotensive patients at high risk of cardiovascular events.

Design: Hypothetical economic analysis.

Methods: Cost analyses were based on known costs of echocardiography, costs of selected cardiovascular medications and prevalence of normotensive LVH in at-risk populations, combined with treatment effect data from studies of hypertensive patients with echocardiographic LVH.

Results: Screening costs per case for echocardiographic LVH are likely to be low, because of the high prevalence of the condition and the low unit cost of echocardiography. Treatment costs are likely to be comparable to those currently deemed acceptable in treating high-risk cardiovascular populations, e.g. the HOPE study population.

Discussion: The costs of screening for and treating LVH in normotensive patients at risk of cardiovascular events do not appear to be prohibitively high. Trials of screening and treatment for normotensive LVH seem therefore to be warranted.

Address correspondence to Dr M.D. Witham, Section of Ageing and Health, Ninewells Hospital and Medical School, Dundee DD1 9SY. e-mail: m.witham{at}dundee.ac.uk


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