Seasonal variation in blood pressure control across US health systems.

Autor:	Nilles EK; Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina., Champon X; Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina., Mulder H; Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina., Shaw KM; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida., Smith M; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida., Lampron ZM; Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina., Wozniak G; American Medical Association, Chicago, Illinois., Chamberlain AM; Department of Quantitative Health Sciences.; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Carton T; Louisiana Public Health Institute, Tulane University, New Orleans, Louisiana., Viera AJ; Department of Family Medicine and Community Health, School of Medicine, Duke University, Durham, North Carolina., Ahmad FS; Departments of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Steinberg BA; Cardiovascular Medicine Division, University of Utah, Salt Lake City, Utah., Chuang CH; Penn State College of Medicine, Penn State University, Hershey., Mctigue KM; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania., McClay JC; University of Nebraska, Omaha, Nebraska., Polonsky TS; Biological Sciences Division, University of Chicago, Chicago, Illinois., Maeztu C; Department of Health Outcomes and Policy, Clinical and Translational Science Institute, University of Florida, Gainesville, Florida., Sanders M; Louisiana Public Health Institute, Tulane University, New Orleans, Louisiana., Warren N; OCHIN, Portland, Oregon., Singh R; Meharry Medical College, Nashville, Tennessee., Liu M; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida., VanWormer JJ; Marshfield Clinic Research Institute, Center for Clinical Epidemiology and Population Health, Marshfield, Wisconsin., Park S; Department of Epidemiology and Biostatistics, University of California, San Francisco, California., Modrow MF; Department of Epidemiology and Biostatistics, University of California, San Francisco, California., Rakotz M; American Medical Association, Chicago, Illinois., Cooper-Dehoff RM; Department of Pharmacotherapy and Translational Research, Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA., Pletcher MJ; Department of Epidemiology and Biostatistics, University of California, San Francisco, California., O'Brien EC; Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2023 May 01; Vol. 41 (5), pp. 751-758. Date of Electronic Publication: 2023 Mar 03.
DOI:	10.1097/HJH.0000000000003396
Abstrakt:	Objective: We aimed to characterize seasonal variation in US population-based blood pressure (BP) control and BP-related metrics and evaluate the association between outdoor temperature and BP control variation. Methods: We queried electronic health records (EHRs) from 26 health systems, representing 21 states, to summarize BP metrics by quarters of 12-month periods from January 2017 to March 2020. Patients with at least one ambulatory visit during the measurement period and a hypertension diagnosis during the first 6 months or prior to the measurement period were included. Changes in BP control, BP improvement, medication intensification, average SBP reduction after medication intensification across quarters and association with outdoor temperature were analyzed using weighted generalized linear models with repeated measures. Results: Among 1 818 041 people with hypertension, the majority were more than 65 years of age (52.2%), female (52.1%), white non-Hispanic (69.8%) and had stage 1/2 hypertension (64.8%). Overall, BP control and process metrics were highest in quarters 2 and 3, and lowest in quarters 1 and 4. Quarter 2 had the highest percentage of improved BP (31.95 ± 0.90%) and average SBP reduction after medication intensification (16 ± 0.23 mmHg). Quarter 3 had the highest percentage of BP controlled (62.25 ± 2.55%) and lowest with medication intensification (9.73 ± 0.60%). Results were largely consistent in adjusted models. Average temperature was associated with BP control metrics in unadjusted models, but associations were attenuated following adjustment. Conclusion: In this large, national, EHR-based study, BP control and BP-related process metrics improved during spring/summer months, but outdoor temperature was not associated with performance following adjustment for potential confounders. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu