Healthcare Resource Use in Uncontrolled Hypertension: An Observational Study in England Using Electronic Health Records
Author(s)
Terry McCormack, MBBS, MRCA, FESC1, Bethan I. Jones, MSc2, Ben Heywood, MSc2, Kiera Lochead, BPharm3, He Gao, PhD3, Jil Billy Mamza, MPH, PhD3.
1Institute of Clinical and Applied Health Research, Hull York Medical School, York, United Kingdom, 2Human Data Sciences, Cardiff, United Kingdom, 3Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom.
1Institute of Clinical and Applied Health Research, Hull York Medical School, York, United Kingdom, 2Human Data Sciences, Cardiff, United Kingdom, 3Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom.
OBJECTIVES: Uncontrolled hypertension (uHTN) is a condition when blood pressure (BP) consistently stays above target despite taking antihypertensive treatments. This research aims to quantify healthcare resource utilisation (HCRU) among patients with uHTN in England.
METHODS: In this retrospective observational study, anonymised, linked primary and secondary care data (Clinical Practice Research Datalink [Aurum] and Hospital Episode Statistics) were used to describe individuals diagnosed with hypertension between January 2018 and December 2023. uHTN was defined as a first BP (index date) above 140/90 mmHg while receiving at least two antihypertensive medications concurrently for ≥30 days (“treated”). HCRU was assessed based on healthcare contacts from index date to end of follow-up. Healthcare costs were calculated using Healthcare Resource Groups (HRGs) National Costs Grouper and NHS tariff for general practitioner (GP) prescriptions, reported as per person per year (PPPY).
RESULTS: Of 130,105 treated patients, 89,291 (68.6%) had uHTN at index. The mean age was 61.9 years (SD: 13.4) and 54.8% were male. The cohort had a mean body mass index of 30.9 kg/m2, with 59.9% current or former smokers. Chronic kidney disease and heart failure were present in 49.6% and 6.3%, respectively; 53.1% received statin therapy. During follow-up, 34.9% of patients had at least one hospital admission (mean 1.9 PPPY), with an average length of stay of 5.7 days PPPY. Patients averaged 14.9 GP contacts, 6.4 outpatient attendances and 0.6 A&E visits PPYY. Total healthcare costs were £2,706.4 PPPY; it was £4,712.8 PPPY for those with inpatient admissions, £970.9 PPPY for those with outpatient attendances and £363.6 PPPY for those with primary care contacts.
CONCLUSIONS: Uncontrolled hypertension remains common among treated patients and is linked to high healthcare resource utilisation and costs, largely due to hospital admissions. These results underscore the need for improved blood pressure management to reduce both clinical and economic burdens.
METHODS: In this retrospective observational study, anonymised, linked primary and secondary care data (Clinical Practice Research Datalink [Aurum] and Hospital Episode Statistics) were used to describe individuals diagnosed with hypertension between January 2018 and December 2023. uHTN was defined as a first BP (index date) above 140/90 mmHg while receiving at least two antihypertensive medications concurrently for ≥30 days (“treated”). HCRU was assessed based on healthcare contacts from index date to end of follow-up. Healthcare costs were calculated using Healthcare Resource Groups (HRGs) National Costs Grouper and NHS tariff for general practitioner (GP) prescriptions, reported as per person per year (PPPY).
RESULTS: Of 130,105 treated patients, 89,291 (68.6%) had uHTN at index. The mean age was 61.9 years (SD: 13.4) and 54.8% were male. The cohort had a mean body mass index of 30.9 kg/m2, with 59.9% current or former smokers. Chronic kidney disease and heart failure were present in 49.6% and 6.3%, respectively; 53.1% received statin therapy. During follow-up, 34.9% of patients had at least one hospital admission (mean 1.9 PPPY), with an average length of stay of 5.7 days PPPY. Patients averaged 14.9 GP contacts, 6.4 outpatient attendances and 0.6 A&E visits PPYY. Total healthcare costs were £2,706.4 PPPY; it was £4,712.8 PPPY for those with inpatient admissions, £970.9 PPPY for those with outpatient attendances and £363.6 PPPY for those with primary care contacts.
CONCLUSIONS: Uncontrolled hypertension remains common among treated patients and is linked to high healthcare resource utilisation and costs, largely due to hospital admissions. These results underscore the need for improved blood pressure management to reduce both clinical and economic burdens.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH122
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)