Economics in hypertension management: cost and quality trade-offs.

Hypertension is a pervasive public health problem with enormous economic as well as medical consequences. Progress in developing more effective, safer and more convenient medications has been remarkable. Similarly, progress in focusing public and professional attention on hypertension has led to earlier treatment and undoubtedly contributed significantly to reduced stroke and cardiovascular mortality rates. Challenges in the next decade will be to resolve residual uncertainties about the balance of benefits and risk of treatment in mild diastolic hypertension and isolated systolic hypertension, and to develop incentives for maximizing the cost-effectiveness of treatment in those for whom treatment is, on balance, beneficial. Quality-of-life parameters will play prominent roles in clinical and policy decisions with respect to each of these challenges.