[PP.01.03] PUBLIC HEALTH SCREENING FOR HYPERTENSION: IS IT COST EFFECTIVE?

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Abstract

Objective:

Hypertension is a known risk factor for cardiovascular morbidity and mortality. Worldwide prevalence of hypertension is high. Individual unawareness of presence of elevated BP is even higher. This is one of the factors that contribute to overall poor control of BP. Aim is to determine the prevalence of hypertension and unawareness of elevated BP at public health screening for hypertension. Cost of detecting a person who was unaware of their elevated BP was also determined.

Design and method:

Data was collected at a health screening campaign for hypertension held at two primary care clinics. Subjects aged 15 years and above were invited to answer a self-administered questionnaire. BP was measured using mercury or automated BP sphygmomanometer by doctors or nurses.

Design and method:

Cost Calculation: The average salary of the doctors and nurses who did the BP measurements for 3 days was used to calculate the cost of detecting hypertension in an individual not aware of their elevated BP.

Results:

2498 subjects (median age 47.9 years, female 50.9% (n = 1263) participated. Ethnic distribution was Malays 52.9% (n = 1322), Chinese 26.1% (n = 651), and Indians 17.7% (n = 441) and the remainder were Sikhs or foreigners. A total of 767 (30.8%) individuals had elevated BP (> 140/90mmHg), 63.2% (n = 457) were not aware they had hypertension. Overall prevalence of known hypertension was 39.9%, n = 996. Among those who were known to have hypertension, 98% (n = 528) were on anti-hypertensive. Those who were on anti-hypertensive, 50.7% (n = 267) had good BP control (BP < 140/90 mmHg).

Results:

The total cost of the doctors and nurses doing the screening for 3 days was RM5019.80 (US$1224) 457 participants were unaware of their elevated BP. Thus the cost of detecting an individual with hypertension was RM10.98. (US$ 2.68).

Conclusions:

The prevalence and unawareness of hypertension is high. The cost of detecting one person who is unaware of his elevated BP was RM 10.98. It is cost effective to hold health screening campaigns to detect a case of hypertension. Detecting elevated BP and reducing unawareness would contribute to the reduction of CV morbidity and mortality attributable to hypertension.

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