Kakoli Roy | Centers for Disease Control and Prevention (original) (raw)

Papers by Kakoli Roy

8th Annual Conference of the American Society of Health Economists, Jun 24, 2019

8th Annual Conference of the American Society of Health Economists, Jun 25, 2019

JAMA network open, Mar 13, 2023

IMPORTANCE Current estimates of productivity losses associated with heart disease and stroke in t... more IMPORTANCE Current estimates of productivity losses associated with heart disease and stroke in the US include income losses from premature mortality but do not include income losses from morbidity. OBJECTIVE To estimate labor income losses associated with morbidity of heart disease and stroke in the US due to missed or lower labor force participation. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used 2019 Panel Study of Income Dynamics data to estimate labor income losses associated with heart disease and stroke by comparing labor income between persons with and without heart disease or stroke, after controlling for sociodemographic characteristics and other chronic conditions and considering the situation of zero labor income (eg, withdrawal from the labor market). The study sample included individuals aged 18 to 64 years who were reference persons or spouses or partners. Data analysis was conducted from June 2021 to October 2022. EXPOSURE The key exposure was heart disease or stroke. MAIN OUTCOMES AND MEASURES The main outcome was labor income, measured for the year 2018. Covariates included sociodemographic characteristics and other chronic conditions. Labor income losses associated with heart disease and stroke were estimated using the 2-part model, in which part 1 is to model the probability that labor income is greater than zero and part 2 is to regress positive labor income, with both parts having the same set of explanatory variables. RESULTS In the study sample consisting of 12 166 individuals (6721 [52.4%] females) representing a weighted mean income of 48299(9548 299 (95% CI, 48299(9545 712-$50 885), the prevalence of heart disease was 3.7% and the prevalence of stroke was 1.7%, and there were 1610 Hispanic persons (17.3%), 220 non-Hispanic Asian or Pacific Islander persons (6.0%), 3963 non-Hispanic Black persons (11.0%), and 5688 non-Hispanic White persons (60.2%). The age distribution was largely even, from 21.9% for the age 25 to 34 years group to 25.8% for the age 55 to 64 years group, except for young adults (age 18-24 years), who made up 4.4% of the sample. After adjustment for sociodemographic characteristics and other chronic conditions, persons with heart disease would receive an estimated

Emerging Infectious Diseases, 2021

Emerging Infectious Diseases, Aug 1, 2005

The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing... more The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing inexpensive oral ciprofloxacin treatment with more expensive injectable ceftriaxone. Further, monitoring antimicrobial resistance requires culture testing, but nonculture gonorrhea tests are rapidly replacing culture. Since the strategies were similar in effectiveness (>99%), we evaluated, from the healthcare system perspective, cost-minimizing strategies for both diagnosis (culture followed by antimicrobial susceptibility tests versus nonculture-based tests) and treatment (ciprofloxacin versus ceftriaxone) of gonorrhea in women. Our results indicate that switching from ciprofloxacin to ceftriaxone is cost-minimizing (i.e., optimal) when the prevalence of gonorrhea is >3% and prevalence of ciprofloxacin resistance is >5%. Similarly, culture-based testing and susceptibility surveillance are optimal when the prevalence of gonorrhea is <13%; nonculture-based testing is optimal (cost-minimizing) when gonorrhea prevalence is >13%.

Nutrients, 2021

Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This st... more Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the ...

The discourse on gender and health frequently asserts that older women are universally more vulne... more The discourse on gender and health frequently asserts that older women are universally more vulnerable to social, economic and health disadvantages than men. Most societies generally observe a nearly universal pattern of longer life expectancy among women, but in itself longer life conveys relatively little about the quality of life and burden of non-fatal disease during the extended years. Empirical studies from developed countries tend to observe that women report higher rates of morbidity and higher healthcare utilization than men. However, morbidity disadvantage among women diminishes with age; gender differences in self-rated health often vanish or are reversed in old age (Arber and Ginn, 1993). Although there is no similar debate regarding higher mortality rates among males, recent studies indicate that the pattern of gender differences in morbidity and healthcare utilization may be more complex, and they vary by measures of health, by symptoms, and across the life course (Macintyre et al., 1996; see also Chapter 12 by Hunt et al.).

American Journal of Preventive Medicine, Aug 1, 2020

Introduction:This study estimates the health, economic, and budgetary impact resulting from gradu... more Introduction:This study estimates the health, economic, and budgetary impact resulting from graduated sodium reductions in the commercially produced food supply of the U.S., which are consistent with draft U.S. Food and Drug Administration voluntary guidance and correspond to Healthy People 2020 objectives and the 2015–2020 Dietary Guidelines for Americans.Methods:Reduction in mean U.S. dietary sodium consumption to 2,300 mg/day was implemented in a microsimulation model designed to evaluate prospective cardiovascular disease–related policies in the U.S. population. The analysis was conducted in 2018–2020, and the microsimulation model was constructed using various data sources from 1948 to 2018. Modeled outcomes over 10 years included prevalence of systolic blood pressure ≥140 mmHg; incident myocardial infarction, stroke, cardiovascular disease events, and cardiovascular disease–related mortality; averted medical costs by payer in 2017 U.S. dollars; and productivity.Results:Reducing sodium consumption is expected to reduce the number of people with systolic blood pressure ≥140 mmHg by about 22% and prevent approximately 895.2 thousand cardiovascular disease events (including 218.9 thousand myocardial infarctions and 284.5 thousand strokes) and 252.5 thousand cardiovascular disease–related deaths over 10 years in the U.S. Savings from averted disease costs are expected to total almost 37billion—mostofwhichwouldbeattributedtoMedicare(37 billion—most of which would be attributed to Medicare (37billion—mostofwhichwouldbeattributedtoMedicare(18.4 billion) and private insurers ($13.4 billion)—and increased productivity from reduced disease burden and premature mortality would account for another $18.2 billion in gains.Conclusions:Systemic sodium reductions in the U.S. food supply can be expected to produce substantial health and economic benefits over a 10-year period, particularly for Medicare and private insurers.

Tobacco Control, Apr 27, 2020

background High-intensity antitobacco media campaigns are a proven strategy to reduce the harms o... more background High-intensity antitobacco media campaigns are a proven strategy to reduce the harms of cigarette smoking. While buy-in from multiple stakeholders is needed to launch meaningful health policy, the budgetary impact of sustained media campaigns from multiple payer perspectives is unknown. Methods We estimated the budgetary impact and time to breakeven from societal, all-payer, Medicare, Medicaid and private insurer perspectives of national antitobacco media campaigns in the USA. Campaigns of 1, 5 and 10 years of durations were assessed in a microsimulation model to estimate the 10 and 20-year health and budgetary impact. Simulation model inputs were obtained from literature and both pubic use and proprietary data sets. results The microsimulation predicts that a 10-year national smoking cessation campaign would produce net

Preventing Chronic Disease, Oct 8, 2020

What is already known on this topic? Screening for colorectal cancer and for female breast and ce... more What is already known on this topic? Screening for colorectal cancer and for female breast and cervical cancers can effectively reduce deaths from these cancers. Yet many preventive services, including cancer screening, remain underutilized in the United States. What is added by this report? Increased use of screening from current levels to 100% would prevent an additional 2,821 deaths from breast cancer, 6,834 deaths from cervical cancer, and 35,530 deaths from colorectal cancer over a lifetime of the respective single-year cohort. Increasing use of colorectal cancer screening would prevent more deaths than an equivalent increase in breast and cervical cancer screening. What are the implications for public health practice? Public health programs incorporating strategies shown to be effective can help increase screening rates. Organized screening approaches leveraging partnerships between public health and primary health care to implement such strategies could be used to reduce the prevalence of these cancers.

Palgrave Macmillan eBooks, Feb 20, 2014

Social Science and Medicine, 2008

Kakoli Roy, PhD, Office of Workforce and Career Development, Office of the Director, Centers for ... more Kakoli Roy, PhD, Office of Workforce and Career Development, Office of the Director, Centers for Disease Control and Prevention Anoshua Chaudhuri, PhD, Department of Economics, San Francisco State University ... Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of CDC. ... Word count: Abstract: 294 words Text: 4857 words (excluding references) Tables: 5 tables ... Empirical studies from developed countries observe that women report worse health and ... Comparable assessments of ...

Journal of the Academy of Nutrition and Dietetics

American journal of preventive medicine, 2016

The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing... more The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing inexpensive oral ciprofloxacin treatment with more expensive injectable ceftriaxone. Further, monitoring antimicrobial resistance requires culture testing, but nonculture gonorrhea tests are rapidly replacing culture. Since the strategies were similar in effectiveness (>99%), we evaluated, from the healthcare system perspective, cost-minimizing strategies for both diagnosis (culture followed by antimicrobial susceptibility tests versus nonculture-based tests) and treatment (ciprofloxacin versus ceftriaxone) of gonorrhea in women. Our results indicate that switching from ciprofloxacin to ceftriaxone is cost-minimizing (i.e., optimal) when the prevalence of gonorrhea is>3 % and prevalence of ciprofloxacin resistance is>5%. Similarly, culture-based

West Nile virus (WNV) is transmitted by mosquitoes and can cause illness in humans ranging from m... more West Nile virus (WNV) is transmitted by mosquitoes and can cause illness in humans ranging from mild fever to encephalitis. In 2002, a total of 4,156 WNV cases were reported in the United States; 329 were in Louisiana. To estimate the economic impact of the 2002 WNV epidemic in Louisiana, we collected data from hospitals, a patient questionnaire, and public offices. Hospital charges were converted to economic costs by using Medicare cost-tocharge ratios. The estimated cost of the Louisiana epidemic was 20.1millionfromJune2002toFebruary2003,includinga20.1 million from June 2002 to February 2003, including a 20.1millionfromJune2002toFebruary2003,includinga10.9 million cost of illness ($4.4 million medical and 6.5millionnonmedicalcosts)anda6.5 million nonmedical costs) and a 6.5millionnonmedicalcosts)anda9.2 million cost of public health response. These data indicate a substantial short-term cost of the WNV disease epidemic in Louisiana. West Nile virus (WNV) is transmitted by mosquitoes and can cause illnesses ranging from simple fevers to encephalitis (1). The presence of this virus in the Western Hemisphere was first recognized in ...

Medical Care, 2019

The following is a synopsis of "Modeling the Health and Budgetary Impacts of a Team-based Hyperte... more The following is a synopsis of "Modeling the Health and Budgetary Impacts of a Team-based Hypertension Care Intervention That Includes Pharmacists, " published in November 2019 in Medical Care.

Public Health Reports, 2019

Objectives: Research suggests that persons who are aware of the risk factors for cardiovascular d... more Objectives: Research suggests that persons who are aware of the risk factors for cardiovascular disease (CVD) are more likely to engage in healthy behaviors than persons who are not aware of the risk factors. We examined whether patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension who self-reported high blood pressure were more likely to fill antihypertensive medication prescriptions and less likely to have CVD-related emergency department visits and hospitalizations (hereinafter, CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure. Methods: We used a large convenience sample from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the United States whose insurance claims included an ICD-9 code associated with hypertension and who complet...

8th Annual Conference of the American Society of Health Economists, Jun 24, 2019

8th Annual Conference of the American Society of Health Economists, Jun 25, 2019

JAMA network open, Mar 13, 2023

IMPORTANCE Current estimates of productivity losses associated with heart disease and stroke in t... more IMPORTANCE Current estimates of productivity losses associated with heart disease and stroke in the US include income losses from premature mortality but do not include income losses from morbidity. OBJECTIVE To estimate labor income losses associated with morbidity of heart disease and stroke in the US due to missed or lower labor force participation. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used 2019 Panel Study of Income Dynamics data to estimate labor income losses associated with heart disease and stroke by comparing labor income between persons with and without heart disease or stroke, after controlling for sociodemographic characteristics and other chronic conditions and considering the situation of zero labor income (eg, withdrawal from the labor market). The study sample included individuals aged 18 to 64 years who were reference persons or spouses or partners. Data analysis was conducted from June 2021 to October 2022. EXPOSURE The key exposure was heart disease or stroke. MAIN OUTCOMES AND MEASURES The main outcome was labor income, measured for the year 2018. Covariates included sociodemographic characteristics and other chronic conditions. Labor income losses associated with heart disease and stroke were estimated using the 2-part model, in which part 1 is to model the probability that labor income is greater than zero and part 2 is to regress positive labor income, with both parts having the same set of explanatory variables. RESULTS In the study sample consisting of 12 166 individuals (6721 [52.4%] females) representing a weighted mean income of 48299(9548 299 (95% CI, 48299(9545 712-$50 885), the prevalence of heart disease was 3.7% and the prevalence of stroke was 1.7%, and there were 1610 Hispanic persons (17.3%), 220 non-Hispanic Asian or Pacific Islander persons (6.0%), 3963 non-Hispanic Black persons (11.0%), and 5688 non-Hispanic White persons (60.2%). The age distribution was largely even, from 21.9% for the age 25 to 34 years group to 25.8% for the age 55 to 64 years group, except for young adults (age 18-24 years), who made up 4.4% of the sample. After adjustment for sociodemographic characteristics and other chronic conditions, persons with heart disease would receive an estimated

Emerging Infectious Diseases, 2021

Emerging Infectious Diseases, Aug 1, 2005

The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing... more The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing inexpensive oral ciprofloxacin treatment with more expensive injectable ceftriaxone. Further, monitoring antimicrobial resistance requires culture testing, but nonculture gonorrhea tests are rapidly replacing culture. Since the strategies were similar in effectiveness (>99%), we evaluated, from the healthcare system perspective, cost-minimizing strategies for both diagnosis (culture followed by antimicrobial susceptibility tests versus nonculture-based tests) and treatment (ciprofloxacin versus ceftriaxone) of gonorrhea in women. Our results indicate that switching from ciprofloxacin to ceftriaxone is cost-minimizing (i.e., optimal) when the prevalence of gonorrhea is >3% and prevalence of ciprofloxacin resistance is >5%. Similarly, culture-based testing and susceptibility surveillance are optimal when the prevalence of gonorrhea is <13%; nonculture-based testing is optimal (cost-minimizing) when gonorrhea prevalence is >13%.

Nutrients, 2021

Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This st... more Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the ...

The discourse on gender and health frequently asserts that older women are universally more vulne... more The discourse on gender and health frequently asserts that older women are universally more vulnerable to social, economic and health disadvantages than men. Most societies generally observe a nearly universal pattern of longer life expectancy among women, but in itself longer life conveys relatively little about the quality of life and burden of non-fatal disease during the extended years. Empirical studies from developed countries tend to observe that women report higher rates of morbidity and higher healthcare utilization than men. However, morbidity disadvantage among women diminishes with age; gender differences in self-rated health often vanish or are reversed in old age (Arber and Ginn, 1993). Although there is no similar debate regarding higher mortality rates among males, recent studies indicate that the pattern of gender differences in morbidity and healthcare utilization may be more complex, and they vary by measures of health, by symptoms, and across the life course (Macintyre et al., 1996; see also Chapter 12 by Hunt et al.).

American Journal of Preventive Medicine, Aug 1, 2020

Introduction:This study estimates the health, economic, and budgetary impact resulting from gradu... more Introduction:This study estimates the health, economic, and budgetary impact resulting from graduated sodium reductions in the commercially produced food supply of the U.S., which are consistent with draft U.S. Food and Drug Administration voluntary guidance and correspond to Healthy People 2020 objectives and the 2015–2020 Dietary Guidelines for Americans.Methods:Reduction in mean U.S. dietary sodium consumption to 2,300 mg/day was implemented in a microsimulation model designed to evaluate prospective cardiovascular disease–related policies in the U.S. population. The analysis was conducted in 2018–2020, and the microsimulation model was constructed using various data sources from 1948 to 2018. Modeled outcomes over 10 years included prevalence of systolic blood pressure ≥140 mmHg; incident myocardial infarction, stroke, cardiovascular disease events, and cardiovascular disease–related mortality; averted medical costs by payer in 2017 U.S. dollars; and productivity.Results:Reducing sodium consumption is expected to reduce the number of people with systolic blood pressure ≥140 mmHg by about 22% and prevent approximately 895.2 thousand cardiovascular disease events (including 218.9 thousand myocardial infarctions and 284.5 thousand strokes) and 252.5 thousand cardiovascular disease–related deaths over 10 years in the U.S. Savings from averted disease costs are expected to total almost 37billion—mostofwhichwouldbeattributedtoMedicare(37 billion—most of which would be attributed to Medicare (37billion—mostofwhichwouldbeattributedtoMedicare(18.4 billion) and private insurers ($13.4 billion)—and increased productivity from reduced disease burden and premature mortality would account for another $18.2 billion in gains.Conclusions:Systemic sodium reductions in the U.S. food supply can be expected to produce substantial health and economic benefits over a 10-year period, particularly for Medicare and private insurers.

Tobacco Control, Apr 27, 2020

background High-intensity antitobacco media campaigns are a proven strategy to reduce the harms o... more background High-intensity antitobacco media campaigns are a proven strategy to reduce the harms of cigarette smoking. While buy-in from multiple stakeholders is needed to launch meaningful health policy, the budgetary impact of sustained media campaigns from multiple payer perspectives is unknown. Methods We estimated the budgetary impact and time to breakeven from societal, all-payer, Medicare, Medicaid and private insurer perspectives of national antitobacco media campaigns in the USA. Campaigns of 1, 5 and 10 years of durations were assessed in a microsimulation model to estimate the 10 and 20-year health and budgetary impact. Simulation model inputs were obtained from literature and both pubic use and proprietary data sets. results The microsimulation predicts that a 10-year national smoking cessation campaign would produce net

Preventing Chronic Disease, Oct 8, 2020

What is already known on this topic? Screening for colorectal cancer and for female breast and ce... more What is already known on this topic? Screening for colorectal cancer and for female breast and cervical cancers can effectively reduce deaths from these cancers. Yet many preventive services, including cancer screening, remain underutilized in the United States. What is added by this report? Increased use of screening from current levels to 100% would prevent an additional 2,821 deaths from breast cancer, 6,834 deaths from cervical cancer, and 35,530 deaths from colorectal cancer over a lifetime of the respective single-year cohort. Increasing use of colorectal cancer screening would prevent more deaths than an equivalent increase in breast and cervical cancer screening. What are the implications for public health practice? Public health programs incorporating strategies shown to be effective can help increase screening rates. Organized screening approaches leveraging partnerships between public health and primary health care to implement such strategies could be used to reduce the prevalence of these cancers.

Palgrave Macmillan eBooks, Feb 20, 2014

Social Science and Medicine, 2008

Kakoli Roy, PhD, Office of Workforce and Career Development, Office of the Director, Centers for ... more Kakoli Roy, PhD, Office of Workforce and Career Development, Office of the Director, Centers for Disease Control and Prevention Anoshua Chaudhuri, PhD, Department of Economics, San Francisco State University ... Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of CDC. ... Word count: Abstract: 294 words Text: 4857 words (excluding references) Tables: 5 tables ... Empirical studies from developed countries observe that women report worse health and ... Comparable assessments of ...

Journal of the Academy of Nutrition and Dietetics

American journal of preventive medicine, 2016

The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing... more The increasing prevalence of ciprofloxacin-resistant Neisseria gonorrhoeae has required replacing inexpensive oral ciprofloxacin treatment with more expensive injectable ceftriaxone. Further, monitoring antimicrobial resistance requires culture testing, but nonculture gonorrhea tests are rapidly replacing culture. Since the strategies were similar in effectiveness (>99%), we evaluated, from the healthcare system perspective, cost-minimizing strategies for both diagnosis (culture followed by antimicrobial susceptibility tests versus nonculture-based tests) and treatment (ciprofloxacin versus ceftriaxone) of gonorrhea in women. Our results indicate that switching from ciprofloxacin to ceftriaxone is cost-minimizing (i.e., optimal) when the prevalence of gonorrhea is>3 % and prevalence of ciprofloxacin resistance is>5%. Similarly, culture-based

West Nile virus (WNV) is transmitted by mosquitoes and can cause illness in humans ranging from m... more West Nile virus (WNV) is transmitted by mosquitoes and can cause illness in humans ranging from mild fever to encephalitis. In 2002, a total of 4,156 WNV cases were reported in the United States; 329 were in Louisiana. To estimate the economic impact of the 2002 WNV epidemic in Louisiana, we collected data from hospitals, a patient questionnaire, and public offices. Hospital charges were converted to economic costs by using Medicare cost-tocharge ratios. The estimated cost of the Louisiana epidemic was 20.1millionfromJune2002toFebruary2003,includinga20.1 million from June 2002 to February 2003, including a 20.1millionfromJune2002toFebruary2003,includinga10.9 million cost of illness ($4.4 million medical and 6.5millionnonmedicalcosts)anda6.5 million nonmedical costs) and a 6.5millionnonmedicalcosts)anda9.2 million cost of public health response. These data indicate a substantial short-term cost of the WNV disease epidemic in Louisiana. West Nile virus (WNV) is transmitted by mosquitoes and can cause illnesses ranging from simple fevers to encephalitis (1). The presence of this virus in the Western Hemisphere was first recognized in ...

Medical Care, 2019

The following is a synopsis of "Modeling the Health and Budgetary Impacts of a Team-based Hyperte... more The following is a synopsis of "Modeling the Health and Budgetary Impacts of a Team-based Hypertension Care Intervention That Includes Pharmacists, " published in November 2019 in Medical Care.

Public Health Reports, 2019

Objectives: Research suggests that persons who are aware of the risk factors for cardiovascular d... more Objectives: Research suggests that persons who are aware of the risk factors for cardiovascular disease (CVD) are more likely to engage in healthy behaviors than persons who are not aware of the risk factors. We examined whether patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension who self-reported high blood pressure were more likely to fill antihypertensive medication prescriptions and less likely to have CVD-related emergency department visits and hospitalizations (hereinafter, CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure. Methods: We used a large convenience sample from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the United States whose insurance claims included an ICD-9 code associated with hypertension and who complet...