Effect of Systolic Blood Pressure Measurement Error on the Cost-Effectiveness of Intensive Blood Pressure Targets
Authors' conclusion
For SPRINT-eligible patients at high cardiovascular risk without diabetes or prior stroke, a target of less than 120 mm Hg seems cost-effective across most settings with SBP measurement error. In scenarios with high error and an increase in CVD risk at low SBPs, a target of less than 130 mm Hg may become cost-effective.
Study context
- Population
- Patients at high CV risk (SPRINT-eligible)
- Comparison
- Systolic blood pressure (SBP) targets <120 vs <130 vs <140 mm Hg, varying SBP measurement error
- Outcome
- Incremental cost-effectiveness ratios (ICERs)
- Follow-up
- Lifetime
Methodological detailsmicrosimulation model, lifetime horizon, health care sector perspective, SPRINT data and published literature
- Microsimulation model
- Lifetime horizon
- Health care sector perspective
- SPRINT data and published literature
Main finding
As reported in the abstract
ICER, <120 vs <130 mm Hg target
ICER
$24 400 per QALY
research-grade SBP measurement (mean error, 0 mm Hg)
ICER
$42 000 per QALY
average measurement error (mean error, 7.3 mm Hg in <120-mm Hg target)
Further findings
ICER for <120 mm Hg target, sensitivity analysis
- ICER >$100 000 per quality-adjusted life-year (QALY) with high error (mean error ≥14.6 mm Hg in <120-mm Hg target)
- ICER >$100 000 per QALY when inflection point for increasing cardiovascular disease (CVD) risk at or above 116 mm Hg
- ICER >$100 000 per QALY with medication-taking disutility of at least 0.003 per antihypertensive medication
Original publication
Effect of Systolic Blood Pressure Measurement Error on the Cost-Effectiveness of Intensive Blood Pressure Targets. Ann Intern Med. Published 19 August 2025. doi:10.
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