Use of electronic health records to characterize patients with uncontrolled hypertension in two large health system networks

Autor: Yuan Lu, Ellen C. Keeley, Eric Barrette, Rhonda M. Cooper-DeHoff, Sanket S. Dhruva, Jenny Gaffney, Ginger Gamble, Bonnie Handke, Chenxi Huang, Harlan M. Krumholz, Caitrin W. McDonough, Wade Schulz, Kathryn Shaw, Myra Smith, Jennifer Woodard, Patrick Young, Keondae Ervin, Joseph S. Ross
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Cardiovascular Disorders, Vol 24, Iss 1, Pp 1-17 (2024)
Druh dokumentu: article
ISSN: 1471-2261
DOI: 10.1186/s12872-024-04161-x
Popis: Abstract Background Improving hypertension control is a public health priority. However, consistent identification of uncontrolled hypertension using computable definitions in electronic health records (EHR) across health systems remains uncertain. Methods In this retrospective cohort study, we applied two computable definitions to the EHR data to identify patients with controlled and uncontrolled hypertension and to evaluate differences in characteristics, treatment, and clinical outcomes between these patient populations. We included adult patients (≥ 18 years) with hypertension (based on either ICD-10 codes of hypertension or two elevated blood pressure [BP] measurements) receiving ambulatory care within Yale-New Haven Health System (YNHHS; a large US health system) and OneFlorida Clinical Research Consortium (OneFlorida; a Clinical Research Network comprised of 16 health systems) between October 2015 and December 2018. We identified patients with controlled and uncontrolled hypertension based on either a single BP measurement from a randomly selected visit or all BP measurements recorded between hypertension identification and the randomly selected visit). Results Overall, 253,207 and 182,827 adults at YNHHS and OneFlorida were identified as having hypertension. Of these patients, 83.1% at YNHHS and 76.8% at OneFlorida were identified using ICD-10-CM codes, whereas 16.9% and 23.2%, respectively, were identified using elevated BP measurements (≥ 140/90 mmHg). A total of 24.1% of patients at YNHHS and 21.6% at OneFlorida had both diagnosis code for hypertension and elevated blood pressure measurements. Uncontrolled hypertension was observed among 32.5% and 43.7% of patients at YNHHS and OneFlorida, respectively. Uncontrolled hypertension was disproportionately higher among Black patients when compared with White patients (38.9% versus 31.5% in YNHHS; p
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