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Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory.

Publication ,  Journal Article
Cooper-DeHoff, RM; Fontil, V; Carton, T; Chamberlain, AM; Todd, J; O'Brien, EC; Shaw, KM; Smith, M; Choi, S; Nilles, EK; Ford, D; Tecson, KM ...
Published in: J Am Heart Assoc
November 2, 2021

Background The National Patient-Centered Clinical Research Network Blood Pressure Control Laboratory Surveillance System was established to identify opportunities for blood pressure (BP) control improvement and to provide a mechanism for tracking improvement longitudinally. Methods and Results We conducted a serial cross-sectional study with queries against standardized electronic health record data in the National Patient-Centered Clinical Research Network (PCORnet) common data model returned by 25 participating US health systems. Queries produced BP control metrics for adults with well-documented hypertension and a recent encounter at the health system for a series of 1-year measurement periods for each quarter of available data from January 2017 to March 2020. Aggregate weighted results are presented overall and by race and ethnicity. The most recent measurement period includes data from 1 737 995 patients, and 11 956 509 patient-years were included in the trend analysis. Overall, 15% were Black, 52% women, and 28% had diabetes. BP control (<140/90 mm Hg) was observed in 62% (range, 44%-74%) but varied by race and ethnicity, with the lowest BP control among Black patients at 57% (odds ratio, 0.79; 95% CI, 0.66-0.94). A new class of antihypertensive medication (medication intensification) was prescribed in just 12% (range, 0.6%-25%) of patient visits where BP was uncontrolled. However, when medication intensification occurred, there was a large decrease in systolic BP (≈15 mm Hg; range, 5-18 mm Hg). Conclusions Major opportunities exist for improving BP control and reducing disparities, especially through consistent medication intensification when BP is uncontrolled. These data demonstrate substantial room for improvement and opportunities to close health equity gaps.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 2, 2021

Volume

10

Issue

21

Start / End Page

e022224

Location

England

Related Subject Headings

  • Male
  • Laboratories
  • Hypertension
  • Humans
  • Female
  • Cross-Sectional Studies
  • Blood Pressure
  • Benchmarking
  • Antihypertensive Agents
  • Adult
 

Citation

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Chicago
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MLA
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Cooper-DeHoff, R. M., Fontil, V., Carton, T., Chamberlain, A. M., Todd, J., O’Brien, E. C., … Pletcher, M. J. (2021). Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory. J Am Heart Assoc, 10(21), e022224. https://doi.org/10.1161/JAHA.121.022224
Cooper-DeHoff, Rhonda M., Valy Fontil, Thomas Carton, Alanna M. Chamberlain, Jonathan Todd, Emily C. O’Brien, Kathryn M. Shaw, et al. “Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory.J Am Heart Assoc 10, no. 21 (November 2, 2021): e022224. https://doi.org/10.1161/JAHA.121.022224.
Cooper-DeHoff RM, Fontil V, Carton T, Chamberlain AM, Todd J, O’Brien EC, et al. Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory. J Am Heart Assoc. 2021 Nov 2;10(21):e022224.
Cooper-DeHoff, Rhonda M., et al. “Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory.J Am Heart Assoc, vol. 10, no. 21, Nov. 2021, p. e022224. Pubmed, doi:10.1161/JAHA.121.022224.
Cooper-DeHoff RM, Fontil V, Carton T, Chamberlain AM, Todd J, O’Brien EC, Shaw KM, Smith M, Choi S, Nilles EK, Ford D, Tecson KM, Dennar PE, Ahmad F, Wu S, McClay JC, Azar K, Singh R, Faulkner Modrow M, Shay CM, Rakotz M, Wozniak G, Pletcher MJ. Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory. J Am Heart Assoc. 2021 Nov 2;10(21):e022224.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 2, 2021

Volume

10

Issue

21

Start / End Page

e022224

Location

England

Related Subject Headings

  • Male
  • Laboratories
  • Hypertension
  • Humans
  • Female
  • Cross-Sectional Studies
  • Blood Pressure
  • Benchmarking
  • Antihypertensive Agents
  • Adult