| Autor: |
Cooper-DeHoff RM; University of Florida Gainesville FL., Fontil V; University of California San Francisco San Francisco CA., Carton T; Louisiana Public Health InstituteTulane University New Orleans LA., Chamberlain AM; Mayo Clinic Rochester MN., Todd J; OCHIN Portland OR., O'Brien EC; Duke University Durham NC., Shaw KM; University of Florida Gainesville FL., Smith M; University of Florida Gainesville FL., Choi S; Duke University Durham NC., Nilles EK; Duke University Durham NC., Ford D; Johns Hopkins Baltimore MD., Tecson KM; Baylor Scott & White Research Institute Dallas TX., Dennar PE; Tulane University New Orleans LA., Ahmad F; Northwestern University Chicago IL., Wu S; UT Health San Antonio TX., McClay JC; University of Nebraska Omaha NE., Azar K; Sutter Health San Francisco CA., Singh R; Meharry Medical College Nashville TN., Faulkner Modrow M; University of California San Francisco San Francisco CA., Shay CM; Genesis Research Dallas TX., Rakotz M; American Medical Association Chicago IL., Wozniak G; American Medical Association Chicago IL., Pletcher MJ; University of California San Francisco San Francisco CA. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American Heart Association [J Am Heart Assoc] 2021 Nov 02; Vol. 10 (21), pp. e022224. Date of Electronic Publication: 2021 Oct 06. |
| DOI: |
10.1161/JAHA.121.022224 |
| Abstrakt: |
Background The National Patient-Centered Clinical Research Network Blood Pressure Control Laboratory Surveillance System was established to identify opportunities for blood pressure (BP) control improvement and to provide a mechanism for tracking improvement longitudinally. Methods and Results We conducted a serial cross-sectional study with queries against standardized electronic health record data in the National Patient-Centered Clinical Research Network (PCORnet) common data model returned by 25 participating US health systems. Queries produced BP control metrics for adults with well-documented hypertension and a recent encounter at the health system for a series of 1-year measurement periods for each quarter of available data from January 2017 to March 2020. Aggregate weighted results are presented overall and by race and ethnicity. The most recent measurement period includes data from 1 737 995 patients, and 11 956 509 patient-years were included in the trend analysis. Overall, 15% were Black, 52% women, and 28% had diabetes. BP control (<140/90 mm Hg) was observed in 62% (range, 44%-74%) but varied by race and ethnicity, with the lowest BP control among Black patients at 57% (odds ratio, 0.79; 95% CI, 0.66-0.94). A new class of antihypertensive medication (medication intensification) was prescribed in just 12% (range, 0.6%-25%) of patient visits where BP was uncontrolled. However, when medication intensification occurred, there was a large decrease in systolic BP (≈15 mm Hg; range, 5-18 mm Hg). Conclusions Major opportunities exist for improving BP control and reducing disparities, especially through consistent medication intensification when BP is uncontrolled. These data demonstrate substantial room for improvement and opportunities to close health equity gaps. |
| Databáze: |
MEDLINE |
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