National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (1)
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- (-) Blood Pressure (27)
- Cardiovascular Conditions (6)
- Care Management (1)
- Case Study (2)
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- Home Healthcare (1)
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- Respiratory Conditions (1)
- Risk (1)
- Screening (3)
- Sleep Problems (1)
- Social Determinants of Health (1)
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- Tobacco Use (1)
- Transplantation (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
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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 25 of 27 Research Studies DisplayedHashemi-Arend A, Vasquez KS, Guishard D
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Investigators implemented two evidence-based interventions not previously tested in senior centers, DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. Using the RE-AIM framework to analyze implementation, they found that change in systolic BP at Month 1 trended towards significance and change in SMBP reached significance at Month 6; food costs increased by 10%. They concluded that this RE-AIM analysis highlighted the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers.
AHRQ-funded; HS021667.
Citation: Hashemi-Arend A, Vasquez KS, Guishard D .
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Nutrients 2022 Nov 18;14(22):4890. doi: 10.3390/nu14224890..
Keywords: Blood Pressure, Patient Self-Management, Elderly, Nutrition, Lifestyle Changes
Shaffer VA, Wegier P, Valentine KD
Patient judgments about hypertension control: the role of patient numeracy and graph literacy.
The purpose of this study was to assess the impact of patient health literacy, numeracy, and graph literacy on perceptions of hypertension control using different forms of data visualization. Forms of visualization included data tables, graphs with raw values, and graphs with smoothed values only. Findings showed that judgments about hypertension data presented as a smoothed graph were significantly more positive than judgments about the same data presented as either a data table or an unsmoothed graph. Hypertension data viewed in tabular form was perceived more positively than graphs of the raw data. Data visualization had the greatest impact on participants with high graph literacy.
AHRQ-funded; HS023328.
Citation: Shaffer VA, Wegier P, Valentine KD .
Patient judgments about hypertension control: the role of patient numeracy and graph literacy.
J Am Med Inform Assoc 2022 Oct 7;29(11):1829-37. doi: 10.1093/jamia/ocac129..
Keywords: Health Literacy, Blood Pressure, Decision Making
Brady TM, Goilav B, Tarini BA
Pediatric home blood pressure monitoring: feasibility and concordance with clinic-based manual blood pressure measurements.
The purpose of this feasibility and concordance study was to evaluate pediatric home blood pressure monitoring in an urban, primarily minority population during the SARS-CoV-2 pandemic. Home blood pressure monitoring (HBPM) may lower the number of needed in-person visits prior to receiving a hypertension diagnosis. Given the challenges of bringing children into offices and the increase in of telehealth services, this study examines whether HBPM offers a feasible and accurate adjunct in pediatric hypertension diagnosis. In this study, the authors concluded that only one-third of consenting patients who appeared for an in-clinic BP measurement and HBPM training provided HBPM data, much of it was not completed as instructed, and one-half had HBPM classifications that were discordant from manual BPs obtained in clinic.
AHRQ-funded; HS026239.
Citation: Brady TM, Goilav B, Tarini BA .
Pediatric home blood pressure monitoring: feasibility and concordance with clinic-based manual blood pressure measurements.
Hypertension 2022 Oct; 79(10):e129-e31. doi: 10.1161/hypertensionaha.122.19578..
Keywords: Children/Adolescents, Blood Pressure
Dorr DA, Richardson JE, Bobo M
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
This study tried to partly address the challenge of developing a patient-facing clinician decision support (CDS) for persistent high blood pressure (HBP). The authors sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools. They implemented a pilot and final survey for hypertension experts and primary care physicians. Five clinical cases were presented that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Fifteen hypertension experts and 14 providers took the pilot and final versions of the survey. The majority (over 80%) of providers felt the recommendations were important yet found them difficult to follow-up to 90% of the time. Provider perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Reasons for variation provided included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Respondents were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools.
AHRQ-funded; HS26849.
Citation: Dorr DA, Richardson JE, Bobo M .
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
Appl Clin Inform 2022 Oct;13(5):1131-40. doi: 10.1055/a-1926-0199..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Decision Making, Provider: Physician
Hashemi A, Vasquez K, Guishard D
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
This study tested whether implementing two evidence-based interventions--DASH-aligned meals provided through an existing congregate meal program, and support for home Self-Measured Blood Pressure (SMBP) monitoring--lowers blood pressure among participants at two senior centers serving low-income, racially diverse communities. Participants were clients aged ≥60, eating ≥4 meals/week at two NYC senior centers. They received DASH-aligned congregate meals, and training in nutrition, BP management education, and personal SMBP device. Primary outcomes was a) change in systolic BP measured by independent health professionals, and b) change in percent with "controlled BP" (Eighth Joint National Committee (JNC-8) Guidelines), at Month 1 compared to Baseline. The authors enrolled 94 participants, with COVID closures interrupting implementation mid-study. Mean systolic BP at Month-1 changed by -4.41 mmHg compared to Baseline. Participants with controlled BP increased at Month 1 and changes in mean BP at Month 1 was significantly correlated with BMI, age, and baseline BP. Mean systolic mean SMBP changed by -6.9 mmHg at Months 5/6.
AHRQ-funded; HS021667.
Citation: Hashemi A, Vasquez K, Guishard D .
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
Nutr Metab Cardiovasc Dis 2022 Aug;32(8):1998-2009. doi: 10.1016/j.numecd.2022.05.018..
Keywords: Elderly, Blood Pressure, Community-Based Practice, Patient Self-Management, Nutrition, Lifestyle Changes, Vulnerable Populations
Hunter KB, Glickman ME, Campos LF
Inferring medication adherence from time-varying health measures.
The purpose of this study was to explore an approach to infer medication adherence rates based on longitudinally recorded health measures that are likely impacted by time-varying adherence behaviors. A modular inferential approach was utilized, which included fitting a two-component model on a training set of patients with detailed adherence data. The researchers assessed the method on a cohort of hypertensive patients, using baseline socio-demographic measures, health comorbidities, and blood pressure measured over time to infer patients' adherence to antihypertensive medication.
AHRQ-funded; HS022112.
Citation: Hunter KB, Glickman ME, Campos LF .
Inferring medication adherence from time-varying health measures.
Stat Med 2022 May 30;41(12):2205-26. doi: 10.1002/sim.9351..
Keywords: Medication, Patient Adherence/Compliance, Blood Pressure
Nugent JT, Young C, Funaro MC
Prevalence of secondary hypertension in otherwise healthy youths with a new diagnosis of hypertension: a meta-analysis.
The objective of this meta-analysis was to estimate prevalence of secondary hypertension among otherwise healthy children with hypertension diagnosed in outpatient settings. The authors found that, when stratified by study setting, there were no significant subgroup differences according to study design or quality, country, participant age range, hypertension definition, or blood pressure device. They concluded that the low prevalence of secondary hypertension among children with a new diagnosis of hypertension reinforces clinical practice guidelines to avoid extensive testing in primary care settings for secondary causes in most children with hypertension.
AHRQ-funded; HS027626.
Citation: Nugent JT, Young C, Funaro MC .
Prevalence of secondary hypertension in otherwise healthy youths with a new diagnosis of hypertension: a meta-analysis.
J Pediatr 2022 May; 244:30-37.e10. doi: 10.1016/j.jpeds.2022.01.047..
Keywords: Children/Adolescents, Blood Pressure
Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD
AHRQ Author: McNellis R
Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension.
In order to address the rapid decline in hypertension control, the National Heart, Lung, and Blood Institute and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention convened a virtual workshop with multidisciplinary national experts. The presentations and discussions included potential reasons for the decline and challenges in hypertension control, possible "big ideas," and multisector approaches that could reverse the current trend while addressing knowledge gaps and research priorities.
AHRQ-authored.
Citation: Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD .
Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension.
Am J Hypertens 2022 Mar 8;35(3):232-43. doi: 10.1093/ajh/hpab182..
Keywords: Blood Pressure, Prevention, Evidence-Based Practice, Cardiovascular Conditions
Gianaris K, Vargas GB, Johnson M
Perceived susceptibility to chronic kidney disease and hypertension self-management among Black and White live kidney donors.
This study examines the theory whether Black kidney donors are more likely than White donors to develop hypertension (HTN) and chronic kidney disease after donation. The authors ascertained electronic medical records and phone survey data from live donors enrolled in the multi-center Wellness and Health Outcomes of LivE Donors (WHOLE-Donor) Hypertension Care Study between May 2013 and April 2020. The study cohort included 318 US-based live kidney donors who developed post-donation HTN with 57.6% female, 78.9% White, 18.6% Black, and a mean age of 46.7 years. Donors with diabetes or who were older than 50 years reported being moderately or strongly concerned about kidney disease. A large majority (87%) reported taking at least one action to help control blood pressure, with no significant differences by sociodemographic factors. They found no substantial differences in perceived susceptibility to kidney disease among Black and White donors, despite published evidence that Black donors may experience greater risk of developing kidney disease than White donors.
AHRQ-funded; HS024600.
Citation: Gianaris K, Vargas GB, Johnson M .
Perceived susceptibility to chronic kidney disease and hypertension self-management among Black and White live kidney donors.
Ethn Dis 2022 Spring;32(2):101-08. doi: 10.18865/ed.32.2.101..
Keywords: Kidney Disease and Health, Chronic Conditions, Racial and Ethnic Minorities, Transplantation, Patient Self-Management, Blood Pressure
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
Eze CE, West BT, Dorsch MP
Predictors of smartphone and tablet use among patients with hypertension: secondary analysis of Health Information National Trends Survey data.
Mobile health technologies like smartphones have enhanced blood pressure (BP) control through remote monitoring. Enhanced BP control is observed when patients can communicate with healthcare providers remotely and receive feedback. The purpose of this cross-sectional, secondary analysis study was to identify the predictors of smartphone and tablet use for achieving health goals and communicating with healthcare providers via SMS among hypertensive patients in the United States. The researchers found that an estimated 36.9% of the weighted adult population in the United States had hypertension, with a mean age of 58.3 years. Notable predictors of using SMS communication with healthcare professionals included electronic communication with doctors or their offices and having a wellness app, after adjusting for demographic and technology-related variables. The likelihood of achieving health-related goals using smartphones or tablets decreased significantly with older age and ownership of basic cellphones but increased significantly for women, married individuals, those with a wellness app, and those who used devices other than smartphones or tablets to monitor health make health treatment decisions, and discuss with a provider using smartphones or tablets.
AHRQ-funded; HS026874; HS026322.
Citation: Eze CE, West BT, Dorsch MP .
Predictors of smartphone and tablet use among patients with hypertension: secondary analysis of Health Information National Trends Survey data.
J Med Internet Res 2022 Jan 24; 24(1):e33188. doi: 10.2196/33188..
Keywords: Blood Pressure, Telehealth, Health Information Technology (HIT)
Fiscella K, He H, Sanders M
Blood pressure visit intensification in treatment (BP-Visit) findings: a pragmatic stepped wedge cluster randomized trial.
This randomized controlled trial evaluated the impact of multimodal strategies on time between visits and on improvement in systolic BP (SBP) among patients with uncontrolled hypertension. A total of 4277 adult patients with diagnosed hypertension and two BPs ≥ 140/90 pre-randomization and at least one visit during the post-randomization control period participated. The core intervention included three clinician hypertension-based trainings, monthly clinician feedback reports, and monthly meetings with practice champions. The main outcomes desired were change in time between visits when BP was not controlled and change in SBP. The intervention did not improve time to the next visit compared with control periods. SBP was reduced by 1.13 mmHg but was not maintained during follow-up. Hypertension control in the practices improved by 5% during intervention and was sustained post-intervention 5.4%.
AHRQ-funded; HS021667.
Citation: Fiscella K, He H, Sanders M .
Blood pressure visit intensification in treatment (BP-Visit) findings: a pragmatic stepped wedge cluster randomized trial.
J Gen Intern Med 2022 Jan;37(1):32-39. doi: 10.1007/s11606-021-07016-9..
Keywords: Blood Pressure, Medication, Cardiovascular Conditions
Kilgallon JL, Gannon M, Burns Z
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
This study’s objective is to develop an intervention for the primary care management of uncontrolled hypertension (HTN) in chronic kidney disease (CKD) utilizing user-centered design principles and behavioral economic principles, test the effectiveness of that intervention, and collect implementation data that will facilitate the application of the intervention in other practice settings. One hundred and eighty-four eligible clinical physicians from 15 practices of The Brigham and Women's Practice -Based Research Network are enrolled in the study. The researchers will use the Reach Effectiveness Adoption Implementation Maintenance framework to assess the intervention’s effectiveness in impacting a change in mean systolic blood pressure between baseline and 6 months.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Kilgallon JL, Gannon M, Burns Z .
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
BMJ Open 2021 Dec 22;11(12):e054065. doi: 10.1136/bmjopen-2021-054065..
Keywords: Blood Pressure, Kidney Disease and Health, Chronic Conditions, Clinical Decision Support (CDS), Health Information Technology (HIT)
Boyd R, Carter E, Moise N
Awareness, knowledge, and attitudes toward screening and treatment of masked hypertension in primary care.
The purpose of this qualitative study was to explore primary care provider (PCP) awareness, knowledge, and attitudes toward masked hypertension (MHT.) The researchers conducted 3 focus groups which included 30 PCPs from 3 medical centers in New York. The analysis and thematic content analysis found that there was low knowledge about the prevalence and impact of MHT, awareness of MHT among the participants varied, and only 2 providers had diagnosed MHT. While some PCPs were receptive to MHT screening after learning about its significance, others perceived the current evidence as insufficient to change practice. There was broad consensus for lifestyle changes for MHT but concerns about a lack of randomized trial evidence for antihypertensive medication, and the possibility of harmful side effects. The researchers concluded that limited PCP knowledge about MHT, insufficient evidence, already overburdened PCPs, and concerns about the accuracy and accessibility of screening tests were key barriers to screening and treatment for MHT.
AHRQ-funded; HS024262.
Citation: Boyd R, Carter E, Moise N .
Awareness, knowledge, and attitudes toward screening and treatment of masked hypertension in primary care.
Am J Hypertens 2021 Dec;34(12):1322-27. doi: 10.1093/ajh/hpab115..
Keywords: Blood Pressure, Screening, Primary Care
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
Wegier P, Belden JL, Canfield SM
Home blood pressure data visualization for the management of hypertension: using human factors and design principles.
Home blood pressure measurements have equal or even greater predictive value than clinic blood pressure measurements regarding cardiovascular outcomes. With advances in home blood pressure monitors, there is an imminent flood of home measurements, but current electronic health record systems lack the functionality to allow us to use this data to its fullest. In this study, the investigators designed a data visualization display for blood pressure measurements to be used for shared decision making around hypertension.
AHRQ-funded; HS023328.
Citation: Wegier P, Belden JL, Canfield SM .
Home blood pressure data visualization for the management of hypertension: using human factors and design principles.
BMC Med Inform Decis Mak 2021 Aug 5;21(1):235. doi: 10.1186/s12911-021-01598-4..
Keywords: Blood Pressure, Cardiovascular Conditions, Health Information Technology (HIT), Care Management
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation: Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Akwo EA, Robinson-Cohen C, Chung CP
Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program.
Apparent treatment-resistant hypertension (ATRH) has been linked to end-stage kidney disease (ESKD) and cardiovascular disease. In this study, the investigators tested the hypothesis that the effect of ATRH on ESKD is greater in Black patients than in White patients and investigated the effect of ATRH on ESKD independent of APOL1 genotype. The investigators concluded that ATRH was associated with an elevated risk of adverse kidney and cardiovascular outcomes. The effect of ATRH on incident ESKD was magnified among patients with reduced kidney function as well as Black patients, independently of APOL1 genotype.
AHRQ-funded; HS026395.
Citation: Akwo EA, Robinson-Cohen C, Chung CP .
Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program.
Hypertension 2021 Aug;78(2):376-86. doi: 10.1161/hypertensionaha.120.16181..
Keywords: Blood Pressure, Kidney Disease and Health, Racial and Ethnic Minorities
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
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
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
Makarem N, Alcántara C, Williams N
Effect of sleep disturbances on blood pressure.
This review summarizes recent literature addressing the association of short sleep duration, shift work, and obstructive sleep apnea with hypertension risk, blood pressure (BP) levels, and 24-hour ambulatory BP. Recommendations include efforts to educate patients and health care providers about the importance of identifying and treating sleep disturbances for hypertension prevention and management. Empirically supported sleep health interventions represent a critical next step to advance this research area and establish causality.
AHRQ-funded; HS024274.
Citation: Makarem N, Alcántara C, Williams N .
Effect of sleep disturbances on blood pressure.
Hypertension 2021 Apr;77(4):1036-46. doi: 10.1161/hypertensionaha.120.14479..
Keywords: Sleep Problems, Blood Pressure, Respiratory 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
Gregg LP, Hedayati SS, Yang H
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
This study looked at whether blood pressure variability (BPV) is associated with cardiovascular outcomes and end-stage kidney disease (ESKD) in patients with chronic kidney disease. The authors studied US veterans with nondialysis chronic kidney disease stages 1-5 and hypertension on nondiuretic antihypertensive monotherapy. This case-control study compared veterans on only one antihypertensive prescription with those who were prescribed a second antihypertensive prescription. Each group had 31,394 participants. BPV was associated with composite cardiovascular events. It was associated with cardiovascular events and death but not ESKD in patients with chronic kidney disease.
AHRQ-funded; HS022418.
Citation: Gregg LP, Hedayati SS, Yang H .
Association of blood pressure variability and diuretics with cardiovascular events in patients with chronic kidney disease stages 1-5.
Hypertension 2021 Mar 3;77(3):948-59. doi: 10.1161/hypertensionaha.120.16117..
Keywords: Kidney Disease and Health, Blood Pressure, Cardiovascular Conditions, Chronic Conditions
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure