Evaluating the true cost of hypertension management: evidence from actual practice
Bibliographic record
Abstract
Hypertension is a prevalent and costly disease and drug cost is the most significant driver of total expense. Therefore, medications such as diuretics, with lower acquisition costs, and equal or better trial-based efficacy versus other classes of antihypertensives, are currently recommended as first-line therapy. However, observational data from actual practice suggest that antihypertensive drug acquisition costs alone are a poor predictor of total treatment cost. This review explores other important determinants of cost which must be considered, such as therapeutic turbulence and persistence on therapy, which cannot be measured with validity within a clinical trial environment. Actual practice data reveal that greater turbulence and poorer persistence is associated with older agents such as diuretics, versus newer, more tolerable medications. On the basis of observational evidence, the gap in total treatment cost associated with older versus newer antihypertensives is significantly less than that which is commonly reported and used as an argument for first-line treatment with diuretics. Continued constructive debate over the implications of observational data for the selection of a first-line antihypertensive therapy is warranted.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".