OBJECTIVES: .  The effect of hypertension on increased risk of cardiovascular disease events has been demonstrated through population based studies, and the predictive value of SBP has been repeatedly demonstrated in risk prediction models derived from such studies.  A recent meta-analysis of evidence regarding SBP reduction by ARB antihypertensives has demonstrated a significant difference in the SBP reduction observed in patients treated with valsartan, compared to those treated with losartan. An economic model has been constructed to evaluate the effect of this difference on the risk of a first CVD event, and the resulting costs. METHODS: .  Inputs for the model are drawn from published sources and publically available datasets.  CVD risk prediction was performed using equations derived from the Framingham Offspring Study cohort.  The model evaluated an untreated group, and groups treated with valsartan, and losartan.  Each treatment group was stratified into those with mild hypertension or moderate hypertension. RESULTS: .  Basecase analyses represent outcomes over 20 years from baseline moderate HTN classification in a US population of age 18 and over.  Valsartan was associated with a marginal cost of $1983 vs. the untreated arm, and a marginal cost of $466 in comparison to losartan.  These costs resulted in estimates of $33,540 per event avoided vs. untreated and $37,474 vs. losartan.  Incremental costs per QALY were $7067 vs. no treatment and $8067 vs. losartan. CONCLUSIONS: .  Analysis results indicate that reduction in SBP from baseline is associated with small reductions in primary CVD rates, and overall CVD treatment costs.  Valsartan performed better than losartan because it was associated with a greater decrease in SBP from baseline (according to meta-analysis results).  Overall, the calculated cost effectiveness ratios for treatment with valsartan indicate that valsartan is likely to be cost-effective when compared to no treatment or treatment with losartan in control of SBP.