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Topics
- (-) Blood Pressure (23)
- Cardiovascular Conditions (6)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (3)
- Community-Based Practice (2)
- COVID-19 (1)
- Decision Making (2)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Elderly (2)
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- Health Information Technology (HIT) (6)
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- Lifestyle Changes (2)
- Maternal Care (3)
- Medication (2)
- Nutrition (2)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Self-Management (3)
- Practice Improvement (1)
- Prevention (2)
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- Provider: Physician (1)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Screening (1)
- Telehealth (4)
- Transplantation (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (1)
- Women (3)
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 23 of 23 Research Studies DisplayedDullabh P, Heaney-Huls KK, Chiao AB
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
This paper describes a pilot intervention of a smartphone app for postpartum monitoring of hypertensive disorders of pregnancy (HDP) that integrates patient-contributed data into electronic health records (EHRs) to support monitoring and clinical decision-making. Results from the pilot evaluation highlighted the resources needed when implementing the app, challenges for integrating an app into the EHR, and the usability and utility of the HDP monitoring app for patient and clinician users. Key observations of the implementation team included the importance of a local clinical champion, more robust patient involvement and support for the remote patient monitoring program, an impetus for EHR developers to adopt data integration standards, and a need to expand the capabilities of the standards to support interventions using patient-contributed data.
AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls KK, Chiao AB .
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
JAMIA Open 2023 Dec; 6(4):ooad098. doi: 10.1093/jamiaopen/ooad098..
Keywords: Electronic Health Records (EHRs), Maternal Care, Blood Pressure, Telehealth, Health Information Technology (HIT), Women
Ross SM, Wang A, Anthony L
Is more better? The impact of implementing more interventions for hypertension control in a practice facilitation study for small- and medium-sized practices.
The purpose of this study was to research the effects of interventions for blood pressure in small- and medium-sized practices. The researchers utilized retrospective analysis on data from Healthy Hearts in the Heartland (H3), a research program conducted in 2016-2018 as part of the Agency for Healthcare Research and Quality's EvidenceNOW initiative, to examine the impact of implementing more interventions for BP control in these settings. The study included 38 H3 practices which met inclusion criteria and researchers assigned each practice to an implementer group (high or low) based on the number of interventions implemented. Practices in the high-implementer group implemented an average of 2.2 additional interventions relative to the low-implementer group. Groups were compared on two measures of BP control: (1) mean percentage of hypertensive patients with a most recent BP below 140/90, and (2) mean systolic and diastolic BP of hypertensive patients. In the first measure, practices in the high-implementer group had better improvement between baseline and the end of the study. Among the 10,150 patients included in the second measure, reductions in mean SBP and DBP were better for the high-implementer group.
AHRQ-funded; HS000078; HS000084; HS023921.
Citation: Ross SM, Wang A, Anthony L .
Is more better? The impact of implementing more interventions for hypertension control in a practice facilitation study for small- and medium-sized practices.
J Hum Hypertens 2023 Nov; 37(11):1007-14. doi: 10.1038/s41371-023-00813-1..
Keywords: Blood Pressure, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Improvement
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.
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
Benziger CP, Suess M, Allen CI
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
This paper’s objective is to describe the protocol for a study that will adapt an electronic health record linked, web-based clinical decision support (CDS) tool called PedsBP that identifies hypertension (HTN) in children for use in a mostly rural health system and to evaluate the effectiveness of PedsBP for repeat of hypertensive level blood pressure (BP) measurements and HTN recognition among youth 6-17 years of age in primary care settings, comparing low-intensity and high-intensity implementation approaches. A pilot of the tool was conducted in 2 primary care clinics and modified prior to the full trial. Forty community-based primary care clinics (or clusters of clinics) were randomly allocated equally to usual care, low-intensity implementation (CDS only), or high-intensity implementation (CDS plus in-person training, monthly use reports, and ongoing communication between study staff and clinics). Eligible patient recruitment started on August 1, 2022 and will continue for 18 months. Primary outcomes will include repeating hypertensive level BP measurements at office visits and clinical recognition of HTN. Secondary outcomes will include lifestyle counseling, dietician referral, and BP at follow-up.
AHRQ-funded; HS027402.
Citation: Benziger CP, Suess M, Allen CI .
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
Contemp Clin Trials 2023 Sep; 132:107293. doi: 10.1016/j.cct.2023.107293..
Keywords: Clinical Decision Support (CDS), Children/Adolescents, Rural Health, Rural/Inner-City Residents, Blood Pressure
Steele DW, Adam GP, Saldanha IJ
Postpartum home blood pressure monitoring: a systematic review.
This systematic review’s objective was to assess the effectiveness of postpartum home blood pressure (BP) monitoring compared with clinic-based follow-up and the comparative effectiveness of alternative home BP-monitoring regimens. The authors included randomized controlled trials (RCTs), nonrandomized comparative studies, and single-arm studies that evaluated the effects of postpartum home BP monitoring (up to 1 year), with or without telemonitoring, on postpartum maternal and infant outcomes, health care utilization, and harm outcomes. After double screening, they extracted demographics and outcomes to SRDR+. Thirteen studies (3 RCTs, 2 nonrandomized comparative studies, and 8 single-arm studies) met eligibility criteria. Home BP monitoring was not associated with the rate of BP treatment initiation but was associated with reduced unplanned hypertension-related hospital admissions. Home BP monitoring, compared with office-based follow-up, was associated with reduced racial disparities in BP ascertainment by approximately 50%. Most patients (ranging from 83.3% to 87.0%) were satisfied with management related to home BP monitoring.
AHRQ-funded; 75Q80120D00001; 75Q80121F32006.
Citation: Steele DW, Adam GP, Saldanha IJ .
Postpartum home blood pressure monitoring: a systematic review.
Obstet Gynecol 2023 Aug 1; 142(2):285-95. doi: 10.1097/aog.0000000000005270..
Keywords: Maternal Care, Blood Pressure, Women, Evidence-Based Practice, Patient-Centered Outcomes Research
Chu CD, Xia F, Du Y
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
The purpose of this cohort study was to assess the extent of albuminuria underdetection from lack of testing and examine its association with CKD treatment. Researchers examined records of adults with hypertension or diabetes, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES) and the Optum deidentified electronic health record (EHR) data set of US health care organizations. The total EHR study population included 192,108 patients; 96.6% with hypertension, and 26.2% with diabetes. The study found that 17.5% of patients had albuminuria testing; of whom 34.3% had albuminuria. Among 158,479 patients who were untested, the estimated albuminuria prevalence rate was 13.4%. Thus, only 35.2% of the projected population with albuminuria had been tested. Albuminuria testing was associated with higher adjusted odds of receiving ACEi or ARB treatment, SGLT2i treatment, and having blood pressure controlled to less than 140/90 mm Hg. The researchers concluded that approximately two-thirds of patients with albuminuria were undetected due to lack of testing.
AHRQ-funded; HS026383.
Citation: Chu CD, Xia F, Du Y .
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
JAMA Netw Open 2023 Jul; 6(7):e2326230. doi: 10.1001/jamanetworkopen.2023.26230..
Keywords: Kidney Disease and Health, Chronic Conditions, Diabetes, Blood Pressure, Evidence-Based Practice
Blecker S, Gannon M, De Leon S
Practice facilitation for scale up of clinical decision support for hypertension management: study protocol for a cluster randomized control trial.
This paper describes a protocol for a study that will be conducted to compare the effect of hypertension-focused clinical decision support (CDS) plus practice facilitation on blood pressure (BP) control, as compared to CDS alone. The investigators will conduct a cluster randomized control trial that will include initial training on the CDS and a review of current guidelines along with follow-up for coaching and integration support. They will randomize 46 small primary care practices in New York City who use the same electronic health record vendor to intervention or control. They will also assess implementation of CDS in all practices and practice facilitation in the intervention group.
AHRQ-funded; HS027120.
Citation: Blecker S, Gannon M, De Leon S .
Practice facilitation for scale up of clinical decision support for hypertension management: study protocol for a cluster randomized control trial.
Contemp Clin Trials 2023 Jun; 129:107177. doi: 10.1016/j.cct.2023.107177..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Blood Pressure, Cardiovascular Conditions
Lindner SR, Balasubramanian B, Marino M
Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW.
The purpose of this study was to estimate decreases in 10-year atherosclerotic cardiovascular disease (ASCVD) risk associated with EvidenceNOW, an initiative spanning multiple states that sought to improve cardiovascular preventive care by providing supportive interventions such as practice facilitation to address the “ABCS”: (A)spirin for high-risk patients, (B)lood pressure control for hypertensive people, (C)holesterol management, and (S)moking screening and cessation counseling. The researchers conducted an analytic modeling study that combined 1) data from 1,278 EvidenceNOW practices collected from 2015 to 2017; (2) patient-level information of 1,295 individuals who participated in the 2015 to 2016 National Health and Nutrition Examination Survey; and (3) 10-year ASCVD risk prediction equations. The study found the average 10-year ASCVD risk of these patients before intervention was 10.11%. Improvements in ABCS due to EvidenceNOW reduced their 10-year ASCVD risk to 10.03% which would prevent 3,169 ASCVD events over 10 years and $150 million in 90-day direct medical costs.
AHRQ-funded; HS023940.
Citation: Lindner SR, Balasubramanian B, Marino M .
Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW.
J Am Board Fam Med 2023 May 8; 36(3):462-76. doi: 10.3122/jabfm.2022.220331R1..
Keywords: Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Blood Pressure
Chu CD, Lenoir KM, Rai NK
Concordance between clinical outcomes in the systolic blood pressure intervention trial and in the electronic health record.
This study examined the role that electronic health records (EHRs) can play in follow-up for concordance with trial-ascertained outcomes. The authors linked EHR and trial data for participants in the Systolic Blood Pressure Intervention Trial (SPRINT), a randomized trial comparing intensive and standard blood pressure targets. Among participants with available EHR data concurrent to trial-ascertained outcomes, they calculated sensitivity, specificity, positive predictive value, and negative predictive value for EHR-recorded cardiovascular disease (CVD) events, using the gold standard of SPRINT-adjudicated outcomes (myocardial infarction (MI)/acute coronary syndrome (ACS), heart failure, stroke, and composite CVD events). They additionally compared the incidence of non-CVD adverse events (hyponatremia, hypernatremia, hypokalemia, hyperkalemia, bradycardia, and hypotension) in trial versus EHR data. Of the 2468 SPRINT participants included, EHR data demonstrated ≥80% sensitivity and specificity, and ≥99% negative predictive value for MI/ACS, heart failure, stroke, and composite CVD events. Positive predictive value ranged from 26% for heart failure to 52% for MI/ACS. Conclusions were that EHR data uniformly identified more non-CVD adverse events and higher incidence rates compared with trial ascertainment.
AHRQ-funded; HS026383.
Citation: Chu CD, Lenoir KM, Rai NK .
Concordance between clinical outcomes in the systolic blood pressure intervention trial and in the electronic health record.
Contemp Clin Trials 2023 May; 128:107172. doi: 10.1016/j.cct.2023.107172..
Keywords: Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions
AA Payán, DD Brown, TT
AHRQ Author: Tierney
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Rodriguez HP, Ciemins EL, Rubio K
Health systems and telemedicine adoption for diabetes and hypertension care.
This study examined differences in telemedicine use for adults with diabetes and/or hypertension across 10 health systems and analyzed practice and patient characteristics associated with greater use. Encounter-level data from the AMGA Optum Data Warehouse for March 13, 2020 to December 31, 2020 were analyzed. This included 3,016,761 clinical encounters from 764,521 adults with diabetes and/or hypertension attributed to 1 of 1207 practice sites with at least 50 system-attributed patients. Telemedicine use time was divided into adoption (weeks 0-4), de-adoption (weeks 5-12), and maintenance (weeks 13-42) periods. Telemedicine use peaked after 4 weeks at 11-42% of weekly encounters. Small practices had lower telemedicine use for adults with diabetes during the maintenance period compared with larger practices, with ownership showing no association with telemedicine use. Practices with higher proportions of Black patients continued their expansion of telemedicine use during the de-adoption and maintenance periods.
Citation: Rodriguez HP, Ciemins EL, Rubio K .
Health systems and telemedicine adoption for diabetes and hypertension care.
Am J Manag Care 2023 Jan; 29(1):42-49. doi: 10.37765/ajmc.2023.89302..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions
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.
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