ArticleBMJ open2018
Characteristics and treatment of African-American and European-American patients with resistant hypertension identified using the electronic health record in an academic health centre: a case-control study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 17 citations in OpenAlex.
- Treatment Intensity, Prescribing Patterns, and Blood Pressure Control in Rural Black Patients with Uncontrolled Hypertension.Journal of racial and ethnic health disparities · 2023Trial
- Evaluation of Blood Pressure Control, Medication Adherence, and Therapeutic Inertia in US Patients With Hypertension Prescribed Multiple Antihypertensives.Journal of the American Heart Association · 2025Article
- Predictive Factors of Apparent Treatment Resistant Hypertension Among Patients With Hypertension Identified Using Electronic Health Records.Journal of general internal medicine · 2025Article
- A flexible symbolic regression method for constructing interpretable clinical prediction models.NPJ digital medicine · 2023Article
- Characteristics, management, and blood pressure control in patients with apparent resistant hypertension in the US.Heliyon · 2023Article
- Whole genome sequence analysis of apparent treatment resistant hypertension status in participants from the Trans-Omics for Precision Medicine program.Frontiers in genetics · 2023Article
- Addressing Hypertension Outcomes Using Telehealth and Population Health Managers: Adaptations and Implementation Considerations.Current hypertension reports · 2022Review
- Blood Pressure Polygenic Scores Are Associated With Apparent Treatment-Resistant Hypertension.Circulation. Genomic and precision medicine · 2022Article
- The Burden of Resistant Hypertension Across the World.Current hypertension reports · 2022Review
- Race/Ethnic Differences in Atherosclerotic Cardiovascular Disease Risk Factors Among Patients With Hypertension: Analysis From 143 Primary Care Clinics.American journal of hypertension · 2021Article
- Article
- Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure.Journal of the American Heart Association · 2020Article
- Increased Incidence of Resistant Hypertension in Patients With Systemic Lupus Erythematosus: A Retrospective Cohort Study.Arthritis care & research · 2020Article
- Renin-Angiotensin-Aldosterone System Modulates Blood Pressure Response During Vascular Endothelial Growth Factor Receptor Inhibition.JACC. CardioOncology · 2019Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo identify patients with hypertension with resistant and controlled blood pressure (BP) using electronic health records (EHRs) in order to elucidate practices in the real-world clinical treatment of hypertension and to enable future genetic studies.
designUsing EHRs, we developed and validated algorithms to identify patients with resistant and controlled hypertension.
settingAn academic medical centre in Nashville, Tennessee. POPULATION: European-American (EA) and African-American (AA) patients with hypertension.
main outcome measuresDemographic characteristics: race, age, gender, body mass index, outpatient BPs and the history of diabetes mellitus, chronic kidney disease stage 3, ischaemic heart disease, transient ischaemic attack, atrial fibrillation and sleep apnoea. MEDICATION TREATMENT: All antihypertensive medication classes prescribed to a patient at the time of classification and ever prescribed following classification.
resultsThe algorithms had performance metrics exceeding 92%. The prevalence of resistant hypertension in the total hypertensive population was 7.3% in EA and 10.5% in AA. At diagnosis, AA were younger, heavier, more often female and had a higher incidence of type 2 diabetes and higher BPs than EA. AA with resistant hypertension were more likely to be treated with vasodilators, dihydropyridine calcium channel blockers and alpha-2 agonists while EA were more likely to be treated with angiotensin receptor blockers, renin inhibitors and beta blockers. Mineralocorticoid receptor antagonists use was increased in patients treated with more than four antihypertensive medications compared with patients treated with three (12.4% vs 2.6% in EA, p<0.001; 12.3% vs 2.8% in AA, p<0.001). The number of patients treated with a mineralocorticoid receptor antagonist increased to 37.4% in EA and 41.2% in AA over a mean follow-up period of 7.4 and 8.7 years, respectively.
conclusionsClinical treatment of resistant hypertension differs in EA and AA patients. These results demonstrate the feasibility of identifying resistant hypertension using an EHR.
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