A global perspective on the costs of hypertension: a systematic review
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Department of Preventive Medicine, Laboratory of International Health, Poznan University of Medical Sciences, Poznan, Poland
Department of Hypertensiology, Angiology and Internal Medicine, Laboratory of Pharmacoeconomics in Hypertension, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2019-09-10
Final revision date: 2019-11-28
Acceptance date: 2019-12-09
Online publication date: 2020-01-31
Publication date: 2020-08-06
Arch Med Sci 2020;16(5):1078–1091
Hypertension, particularly untreated, leads to serious complications and contributes to high costs incurred by the whole society. The aim of the review was to carry out a social and economic comparison of various categories of hypertension costs from different countries.

Material and methods:
The study was a systematic review. PubMed, Cochrane Library and Google Scholar databases were searched. Hypertension costs were analyzed in 8 cost categories. An attempt was made to determine whether selected economic and social factors (such as HDI or GDP) influenced hypertension costs.

The review included data from 15 countries: Brazil, Cambodia, Canada, China, Greece, Indonesia, Italy, Jamaica, Kyrgyzstan, Mexico, Poland, Spain, USA, Vietnam and Zimbabwe. The papers included in the review were heterogeneous with respect to cost categories, which made comparisons difficult. The average total costs of hypertension for all the studied countries, calculated per person, amounted to 630.14 Int$, direct costs – 1,497.36 Int$, and indirect costs – 282.34 Int$. The ranking of countries by costs and by selected economic and social indices points at the possible relationship between these indices and hypertension costs.

The costs of hypertension calculated per country reached the region of several dozen billion Int$. Other sources usually showed lower costs than those presented in this review. This indicates a growth in costs from year to year and the future increasing burden on society. Globally uniform cost terminology and cost calculation standards need to be developed. That would facilitate making more informed decisions regarding fund allocation in hypertension management schemes.