• Gerald Richardson, Lesley Godfrey, Hugh Gravelle, and Ian Watt.
• Centre for Health Economics, University of York, York, UK. gar2@york.ac.uk
• Br J Gen Pract. 2004 Oct 1; 54 (507): 765771765-71.

BackgroundHypertension is a major public health concern and, as the population ages, the size of the problem is likely to increase. However, detection rates and treatment of hypertension have been low. The introduction of new guidelines for the detection and treatment of hypertension have been encouraged but without any consideration to their cost-effectiveness.AimTo assess the potential cost-effectiveness of implementing new guidelines for the treatment of hypertension in general practice.Design Of StudyModel examining the incremental costs and effects of the new guidelines compared with the old.SettingA large general practice in north Yorkshire.MethodTwo thousand and twenty-three patients reporting for a new health patient check had the costs and outcomes under the old and new guidelines estimated.ResultsImplementing new guidelines for the detection, management, and treatment of hypertension in a primary care setting is more costly than the implementation of previous guidelines, but more effective in reducing the risk of cardiovascular disease. The incremental cost per cardiovascular disease event avoided is ?30 000, although sensitivity analysis shows that the estimate is subject to considerable uncertainty.ConclusionsCompared with previous guidelines, introducing new guidelines for the management and treatment of hypertension in new patients in general practice is likely to be cost-effective. However, the workforce implications for general practitioners (GPs) and practice nurses should be considered.

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