Abstract
BACKGROUND: Hypertension is a prevalent global health issue with far-reaching consequences. It impacts millions of individuals worldwide and poses significant risks to overall health. We aimed to explore and compare the cost-effectiveness and clinical efficacy of single, dual, and triple antihypertensive therapies in the management of blood pressure. METHOD: This retrospective observational study evaluated the cost effectiveness of antihypertensive therapy from the inpatient records of hypertensive urgency patients from January 2022 to December 2022. Data was extracted from the medical records including crucial information such as MR number, name, gender, weight, dates of admission and discharge, co-morbidities, therapy type, prescribed drugs and doses, and blood pressure readings. Employing standard costing techniques, the study calculated direct medical costs associated with the patient's stay, medical care, nursing, and medication charges, considering the timeframe of August 2023. Data was analyzed using SPSS and Microsoft Excel. Mann Whitney and Kruskall Walis test was performed for statistical analysis. RESULTS: Out of 120 patients, the majority were male 55% and between the age group 61-80 years i.e., 45%. The analysis revealed a statistically significant impact on systolic blood pressure across the different therapies. Monotherapy resulted in a higher median systolic BP (140.0 mmHg [IQR 6.27]) compared to dual therapy (136.7 mmHg [IQR 6.7]) and triple therapy (133.3 mmHg [IQR 10.0]), with a significant difference (p = 0.000). In terms of cost-effectiveness, triple therapy demonstrated the lowest average cost-effectiveness ratio (ACER) for systolic BP control PKR 1803, while dual therapy was the most cost-effective for diastolic BP management with PKR 2438. CONCLUSION: The study concluded triple therapy as the most cost effective strategy for reducing systolic blood pressure, demonstrating its efficacy in blood pressure management. Conversely, dual therapy proved optimal for controlling diastolic blood pressure. REGISTRATION: IRB # 0126 - 23 Dated: 24 July 2023.