ArticleJournal of the American Heart Association2016
Treatment Intensification for Hypertension in US Ambulatory Medical Care.
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Pooled it
- The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019Guideline
- Clinical inertia in the pharmacological management of hypertension: A systematic review and meta-analysis.Medicine · 2018Pooled it
- Clinical Decision Support System, Antihypertensive Treatment Intensification, and Blood Pressure Control: A Post Hoc Secondary Analysis of a Cluster Randomized Trial.JAMA network open · 2026Trial
- Analysis of Therapeutic Inertia and Race and Ethnicity in the Systolic Blood Pressure Intervention Trial: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2022Trial
- The Impact of Antihypertensive De-escalation: A Secondary Analysis of Systolic Blood Pressure Intervention Trial (SPRINT).High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Article
- Antihypertensive Medication Patterns in Patients with Hypertension that is Harder to Control: Insights from the EnligHTN Study.Advances in therapy · 2026Article
- Medicaid coverage for fixed-dose combination antihypertensive medications - fifty states and Washington, D.C., 2022.Journal of human hypertension · 2026Article
- Poor long-term cardiovascular risk factor management after acute coronary syndrome: An observational cohort study.Journal of internal medicine · 2026Observational
- Understanding clinical inertia in hypertension management: clues from real-world data.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Organizational Determinants to Hypertension Management: Adapting a Health Equity Framework to Examine Processes at Two Academic Health Systems.Journal of general internal medicine · 2025Article
- Overcoming Clinical Inertia in the Treatment of Hypertension.Internal medicine (Tokyo, Japan) · 2025Article
- Association of Questionnaire-Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Comparative Efficacy of Hypertension Management Strategies.The International journal of angiology : official publication of the International College of Angiology, Inc · 2024Article
- Treatment intensification and therapeutic inertia of antihypertensive therapy among patients with type 2 diabetes and hypertension with uncontrolled blood pressure.Scientific reports · 2024Article
- Age and Comorbidities Are Associated With Therapeutic Inertia Among Older Adults With Uncontrolled Blood Pressure.American journal of hypertension · 2024Article
- Age and sex disparities in blood pressure control and therapeutic inertia: Impact of a quality improvement program.American journal of preventive cardiology · 2024Article
- Article
- Cross-sectional survey of hypertension management in clinical practice in Japan: the Kanagawa Hypertension Study 2021 conducted in collaboration with Japan Medical Association Database of Clinical Medicine.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Article
- Improving Blood Pressure Control in the United States: At the Heart of Million Hearts 2027.American journal of hypertension · 2023Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertension is widely prevalent yet remains uncontrolled in nearly half of US hypertensive adults. Treatment intensification for hypertension reduces rates of major cardiovascular events and all-cause mortality, but clinical inertia remains a notable impediment to further improving hypertension control. This study examines the likelihood and determinants of treatment intensification with new medication in US ambulatory medical care. METHODS AND
resultsUsing the nationally representative National Ambulatory Medical Care Survey (2005-2012) and National Hospital Ambulatory Medical Care Survey (2005-2011), we identified adult primary care visits with diagnosed hypertension and documented blood pressure exceeding goal targets and assessed the weighted prevalence and odds ratios of treatment intensification by initiation or addition of new medication. Approximately 41.7 million yearly primary care visits (crude N: 14 064, 2005-2012) occurred among US hypertensive adults with documented blood pressure ≥140/90 mm Hg, where treatment intensification may be beneficial. However, only 7.0 million of these visits (95% confidence interval 6.2-7.8 million) received treatment intensification with new medication, a weighted prevalence of 16.8% (15.8% to 17.9%). This proportion was consistently low and decreased over time. This decline was largely driven by decreasing medication initiation levels among patients on no previous hypertension medications from 31.8% (26.0% to 38.4%) in 2007 to 17.4% (14.0% to 21.4%) in 2012, while medication addition levels remained more stable over time.
conclusionsUS hypertensive adults received treatment intensification with new medication in only 1 out of 6 primary care visits, a fraction that is declining over time. A profound increase in intensification remains a vast opportunity to maximally reduce hypertension-related morbidity and mortality nationwide.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.