Original article Lifetime Medical Expenditures Among Hypertensive Men and Women in the United States Rituparna Basu, PhD a, * , Patrick M. Krueger, PhD b,c , David R. Lairson, PhD d , Luisa Franzini, PhD d a University of California, San Francisco, CA b University of Colorado, Denver, CO c University of Colorado, Boulder, CO d University of Texas Health Science Center at Houston, TX Article history: Received 18 April 2010; Received in revised form 25 December 2010; Accepted 27 December 2010 abstract Objective: Our objective was to estimate lifetime medical expenditures that can be attributed to hypertension, by gender, in the United States, given important gender differences in both survival and medical expenditures. Methods: We estimated lifetime medical expenditures among hypertensive and nonhypertensive men and women aged 20 and older. Expenditures were estimated from the 2001 to 2004 Medical Expenditure Panel Survey and life expec- tancies were estimated from the 1986 to 2002 National Health Interview Survey Linked Mortality Files. Assuming that medical technology, the cost of health care services, the incidence of disease, and survival were fixed, the cross-sectional age-specific expenditures and the survival profiles were used to estimate the lifetime expenditures from ages 20 to older than 85. Principal Findings: The estimated lifetime expenditure for an average life table individual at age 20 was $188,300 for hypertensive men and $254,910 for hypertensive women; however, a greater share of lifetime expenditures can be attributed to hypertension among men ($88,033) than among women ($40,960). Conclusion: Although hypertensive women had greater lifetime expenditures than hypertensive men, hypertension was associated with a greater increase in lifetime expenditures for men than for women. Gender differences in both survival and health care utilization have important implications for gender differences in lifetime medical expenditures. Copyright Ó 2011 by the Jacobs Institute of Women’s Health. Published by Elsevier Inc. Introduction Hypertension, an important risk factor for expensive and deadly conditions including heart diseases and stroke, is very common among men and women in the United States. In 2003, there were about 65 million hypertensive individuals in the United States, more than 50% of whom were women (Fields et al., 2004) and more women had hypertension listed as the primary cause of death than men (American Heart Association, 2006). We sought to examine differences in lifetime medical expenditures among hypertensive and nonhypertensive men and women in the United States because hypertension is a prevalent and important risk factor for morbidity and mortality, and because there are substantial gender differences in medical expenditures and life expectancy. Cross-sectional studies have found substantial gender differences in hypertension-attributable medical expenditures (Hodgson & Cohen, 1999; Hodgson & Cai, 2001). Women gener- ally have higher overall hypertension-attributable medical expenditures than men, although gender differences vary with type of care (Hodgson & Cai, 2001). Basu, Franzini, Krueger, and Lairson (2010) examined the joint impact of age and gender on expenditures and found that at ages 50 and older, women had lower hypertension-attributable health care expenditures than men for services delivered in physician’s office, prescription drugs, and outpatient clinics. Women are also less likely than men to have received recommended cardiac procedures after adjusting for age, race, severity of myocardial infarction, comorbidity, and geographic location (Weitzman et al., 1997). Other recent studies (Correa-de-Araujo et al., 2006; Chou et al., * Correspondence to: Rituparna Basu, PhD, University of California, San Francisco, 3333 California Street, Suite 420, Box #0613, San Francisco, CA 94118. E-mail address: BasuR@pharmacy.ucsf.edu (R. Basu). www.whijournal.com 1049-3867/$ - see front matter Copyright Ó 2011 by the Jacobs Institute of Women’s Health. Published by Elsevier Inc. doi:10.1016/j.whi.2010.12.004 Women's Health Issues 21-3 (2011) 246–253