National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Blood Pressure (14)
- Cardiovascular Conditions (3)
- Care Management (1)
- Case Study (4)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Community-Based Practice (1)
- Diagnostic Safety and Quality (2)
- Evidence-Based Practice (14)
- (-) Guidelines (14)
- Heart Disease and Health (1)
- Home Healthcare (2)
- Maternal Care (1)
- Medication (1)
- Pregnancy (1)
- Prevention (6)
- Primary Care (2)
- Screening (8)
- Social Determinants of Health (1)
- U.S. Preventive Services Task Force (USPSTF) (10)
- Women (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedHenderson JT, Webber EM, Thomas RG
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to conduct a systematic review to update the evidence on the effectiveness of screening for hypertensive disorders of pregnancy with the purpose of informing the U.S. Preventive Services Task Force. The main outcome was Morbidity or mortality, with measures of health-related quality of life. The review included 6 fair-quality studies comparing changes in prenatal screening practices with routine screening at in-person office visits (usual care). This systematic review did not find evidence that any alternate screening strategies for hypertensive disorders of pregnancy had increased effectiveness over routine blood pressure measurement at in-person prenatal visits. No harms of the different screening strategies were identified.
AHRQ-funded; 75Q80120D00004.
Citation: Henderson JT, Webber EM, Thomas RG .
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Sep 19; 330(11):1083-91. doi: 10.1001/jama.2023.4934..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Prevention, Evidence-Based Practice, Guidelines, Maternal Care, Women
Bryant KB, Green MB, Shimbo D
Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go.
This analysis examined how historical use of home blood pressure monitoring (HBPM) aligns with current out-of-office BP monitoring recommendations for hypertensive US adults without a previous hypertension diagnosis and how HBPM use varies by patient characteristics. A cohort of 7185 adults aged 20 years or older without a diagnosis of hypertension or antihypertensive medication use and a high office BP (≥130/80 mm Hg) who participated in the National Health and Nutrition Examination Survey (NHANES) 2009 to 2014 cycle were included. Participants who answered as having self-initiated or physician recommended HBPM were categorized as having used or having been told to use HBPM. The authors estimate that 31.4 million US adults did not have diagnosed hypertension, were not taking antihypertensive medications, and had an office BP ≥130/80 mm Hg. Out of that population, 95.3% would have met criteria to undergo out-of-office BP monitoring by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Only 3.6% (1.1 million) were told to use HBPM, and 15.7% had used HPBM. There were no differences in use by race/ethnicity, sex, health insurance status, or source of routine healthcare. The authors suggest the use of a telemonitoring system to improve ease of HBPM.
AHRQ-funded; HS024262.
Citation: Bryant KB, Green MB, Shimbo D .
Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go.
Hypertension 2022 Feb;79(2):e15-e17. doi: 10.1161/hypertensionaha.121.18463..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Home Healthcare, Guidelines, Evidence-Based Practice
Razon N, Hessler D, Bibbins-Domingo K
How hypertension guidelines address social determinants of health: a systematic scoping review.
Patient-level and community-level social and economic conditions impact hypertension risk and control. In this study, the investigators examined adult hypertension management guidelines to explore whether and how existing guidelines refer to social care activities. The investigators concluded that information about social determinants of health is included in many hypertension guidelines, but few guidelines provide clear guidance for clinicians or health systems on how to identify and address social risk factors in the context of care delivery.
AHRQ-funded; HS022241.
Citation: Razon N, Hessler D, Bibbins-Domingo K .
How hypertension guidelines address social determinants of health: a systematic scoping review.
Med Care 2021 Dec;59(12):1122-29. doi: 10.1097/mlr.0000000000001649..
Keywords: Social Determinants of Health, Guidelines, Evidence-Based Practice, Blood Pressure
Fan T, Tan M
AHRQ Author: Fan T
Screening for hypertension in adults.
This Putting Prevention into Practice case study involves a 23-year-old patient presenting for a wellness visit with no concerns. The patient’s medical record shows a history of polycystic ovary syndrome, blood pressure of 110/70 mm Hg from a visit one year ago, and a body mass index of 28.2. Three questions are presented, along with answers.
AHRQ-authored.
Citation: Fan T, Tan M .
Screening for hypertension in adults.
Am Fam Physician 2021 Aug 1;104(2):193-94..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Prevention, Case Study
Carey RM, Wright JT, Taler SJ
Guideline-driven management of hypertension: an evidence-based update.
This paper is an evidence-based update to the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. The authors conducted a literature review of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics included blood pressure (BP) measurement, patient evaluation, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and BP threshold for drug therapy, lifestyle and pharmacological management, treatment target BP goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches.
AHRQ-funded; HS027944.
Citation: Carey RM, Wright JT, Taler SJ .
Guideline-driven management of hypertension: an evidence-based update.
Circ Res 2021 Apr 2;128(7):827-46. doi: 10.1161/circresaha.121.318083..
Keywords: Blood Pressure, Guidelines, Evidence-Based Practice, Cardiovascular Conditions, Chronic Conditions
Mabry-Hernandez I, Baker SM
AHRQ Author: Mabry-Hernandez I
Screening for high blood pressure in children and adolescents.
This Putting Prevention into Practice case study concerns a 10-year-old boy with obesity and a family history significant for hypertension and hyperlipidemia presenting for a well-child examination. The parents express concern about their child’s risk for hypertension and ask whether they should be monitoring his blood pressure. Three questions are presented, along with answers.
AHRQ-authored.
Citation: Mabry-Hernandez I, Baker SM .
Screening for high blood pressure in children and adolescents.
Am Fam Physician 2021 Mar 15;103(6):371-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Guidelines, Evidence-Based Practice, Prevention, Case Study
Moise N, Phillips E, Carter E
Design and study protocol for a cluster randomized trial of a multi-faceted implementation strategy to increase the uptake of the USPSTF hypertension screening recommendations: the EMBRACE study.
The US Preventive Services Task Force (USPSTF) recommends out-of-office blood pressure (BP) testing to exclude white coat hypertension prior to hypertension diagnosis. Despite improved availability and coverage of home and 24-h ambulatory BP monitoring (HBPM, ABPM), both are infrequently used to confirm diagnoses. In this study, the investigators used the Behavior Change Wheel (BCW) framework, a multi-step process for mapping barriers to theory-informed behavior change techniques, to develop a multi-component implementation strategy for increasing out-of-office BP testing for hypertension diagnosis.
AHRQ-funded; HS025198; HS024262.
Citation: Moise N, Phillips E, Carter E .
Design and study protocol for a cluster randomized trial of a multi-faceted implementation strategy to increase the uptake of the USPSTF hypertension screening recommendations: the EMBRACE study.
Implement Sci 2020 Aug 8;15(1):63. doi: 10.1186/s13012-020-01017-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Guidelines, Evidence-Based Practice, Cardiovascular Conditions
Patil SJ, Koopman RJ, Belden J
The role of home BP monitoring: answers to 10 common questions.
This review examines what role home blood-pressure monitoring (HBPM) should take in the management of patients with hypertension. The answers to ten evidence-based questions, with reference to USPSTF recommendations, are used to provide insight. These questions include: Can HPBM be used to confirm a hypertension diagnosis? What are the diagnostic and treatment targets for HBPM? Does HBPM improve control of hypertension? Does HBPM help improve medication adherence? Does HBPM improve BP outcomes?
AHRQ-funded; HS023328.
Citation: Patil SJ, Koopman RJ, Belden J .
The role of home BP monitoring: answers to 10 common questions.
J Fam Pract 2019 Jan/Feb;68(1):29-33..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Home Healthcare, Evidence-Based Practice, Care Management, Guidelines
Egan BM, Li J, Davis RA
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. This article discusses differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
AHRQ-funded; P30 HS021667.
Citation: Egan BM, Li J, Davis RA .
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
J Clin Hypertens 2018 Jun;20(6):991-1000. doi: 10.1111/jch.13314..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Guidelines, Blood Pressure, Medication, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Henderson JT, Thompson JH, Burda BU
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the benefits and harms of preeclampsia screening and risk assessment for the US Preventive Services Task Force. Their review of 21 studies concluded that evidence to estimate benefits and harms of preeclampsia screening and the test performance of different screening approaches over the course of pregnancy was limited. Externally validated risk prediction models had limited applicability.
AHRQ-funded; 290201200151I.
Citation: Henderson JT, Thompson JH, Burda BU .
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Apr 25;317(16):1668-83. doi: 10.1001/jama.2016.18315.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Women, Prevention
Fontil V, Bibbins-Domingo K, Nguyen OK
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
The researchers examined adherence to guideline-concordant hypertension treatment practices at community health centers (CHCs) compared with private physicians' offices.: Medicaid patients at CHCs were as likely as privately insured individuals to receive a new medication for uncontrolled hypertension, whereas Medicaid patients at private physicians' offices were less likely to receive a new medication.
AHRQ-funded; HS018090.
Citation: Fontil V, Bibbins-Domingo K, Nguyen OK .
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
Health Serv Res 2017 Apr;52(2):807-25. doi: 10.1111/1475-6773.12516.
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Keywords: Blood Pressure, Primary Care, Community-Based Practice, Guidelines, Evidence-Based Practice
Ngo-Metzger O, Blitz J
AHRQ Author: Ngo-Metzger Q
Screening for high blood pressure in adults.
This case study involves a 55-year-old black man who presents for a blood pressure evaluation. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger O, Blitz J .
Screening for high blood pressure in adults.
Am Fam Physician 2016 Mar 15;93(6):511-2.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Guidelines, Case Study, Evidence-Based Practice
Mabry-Hernandez I, Chu K
AHRQ Author: Mabry-Hernandez I
Screening for primary hypertension in children and adolescents.
This article presents a case study about a 14-year-old black adolescent who presents for a routine school physical examination. Her mother tells you that she and her husband have hypertension, and they worry about their daughter’s blood pressure. She asks you whether her child should be periodically checked for high blood pressure. The case study was coordinated with the AHRQ-administered US Preventive Services Task Force and published online on the American Academy of Family Practice website.
Citation: Mabry-Hernandez I, Chu K .
Screening for primary hypertension in children and adolescents.
Am Fam Physician 2015 Feb 15;91(4):257-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Prevention, Case Study
Piper MA, Evans CV, Burda BU
Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force.
The purpose of this paper is to update a systematic review on the benefits and harms of screening for high BP in adults and to summarize evidence on rescreening intervals and diagnostic and predictive accuracy of different BP methods for cardiovascular events. It concluded that evidence supports ambulatory blood pressure monitoring as the reference standard for confirming elevated office BP screening results to avoid misdiagnosis and overtreatment of persons with isolated clinic hypertension.
AHRQ-funded; 290201200151I.
Citation: Piper MA, Evans CV, Burda BU .
Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Feb 3;162(3):192-204. doi: 10.7326/m14-1539..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Diagnostic Safety and Quality, Screening, Evidence-Based Practice, Guidelines