OBJECTIVES: To assess the economic impact in the Mexican Health System of a hypertensive population preventive program (HPPP) in order to shift cardiovascular risk on the long-term. METHODS: Costs and health benefits were forecasted for the period 2005-2025 after the implementation of a control and detention program in hypertensive population in Mexico. Incidence and prevalence data was obtained from a Mexican National Survey (Encuesta Nacional de Salud 2000) for population between 20-59 yrs. Preventive actions included in the program were: opportune detention of hypertension with two measures of arterial hypertension per year to all adult population attended in the Mexican Health System. Secondary prevention actions consisted in changes in life styles and intensive pharmacologic treatment in patients with uncontrolled hypertension. Healthcare costs data was obtained from the Social Security Mexican Institute (IMSS) databases and the HPPP effectiveness was taken from published literature for worldwide similar preventive programs. Framingham tables were used to constructed disease progression simulations and effectiveness measures used in the assessment were the number of new cases of patients controlled and cardiovascular events avoided. The analysis was conducted from the healthcare payer's perspective (only direct medical costs were used). RESULTS: Through 20-years analysis period, the total number of hypertensive cases remained unchanged. Nevertheless, the number of new hypertensive cases controlled increased in 74.8% which represented a reduction of 6.6 millions cases uncontrolled. On the same time horizon, the HPPP showed a decrease of 16.9% in the total number of cardiovascular events which represented approximately 1.7 millions less complications in the Mexican Health System. The latter could represent in the future net savings in US$1,652 millions compared to the actual scenario. CONCLUSION: Preventive actions included in control and detention hypertensive programs resulted to be cost-effectiveness policies, and showed to be cost saving strategies in the long-term.