Evidence map›Paper›PMID 39358502›Full record

ArticleJournal of general internal medicine2025

Predictive Factors of Apparent Treatment Resistant Hypertension Among Patients With Hypertension Identified Using Electronic Health Records.

Shanshan Lin, Yea-Jen Hsu, Ji Soo Kim, John W Jackson, Jodi B Segal

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shanshan LinDivision of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Yea-Jen HsuDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Ji Soo KimDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
John W JacksonCenter for Drug Safety and Effectiveness, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Jodi B SegalDivision of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jsegal@jhmi.edu.ORCID 0000-0003-3978-9662

Funding

Systems Science for Translational Health Disparities ResearchK01HL145320 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI JACKSON, JOHN WILLIAM · 2019 to 2023
$832k
NHLBI NIH HHS K01 HL145320NHLBI NIH HHS K01HL145320
6 · The paper itself

Abstract

backgroundEarly identification of a patient with resistant hypertension (RH) enables quickly intensified treatment, short-interval follow-up, or perhaps case management to bring his or her blood pressure under control and reduce the risk of complications.

objectiveTo identify predictors of RH among individuals with newly diagnosed hypertension (HTN), while comparing different prediction models and techniques for managing missing covariates using electronic health records data.

designRisk prediction study in a retrospective cohort.

participantsAdult patients with incident HTN treated in any of the primary care clinics of one health system between April 2013 and December 2016. MAIN MEASURES: Predicted risk of RH at the time of HTN identification and candidate predictors for variable selection in future model development. KEY

resultsAmong 26,953 individuals with incident HTN, 613 (2.3%) met criteria for RH after 4.7 months (interquartile range, 1.2-11.3). Variables selected by the least absolute shrinkage and selection operator (LASSO), included baseline systolic blood pressure (SBP) and its missing indicator (a dummy variable created if baseline SBP is absent), use of antihypertensive medication at the time of cohort entry, body mass index, and atherosclerosis risk. The random forest technique achieved the highest area under the curve (AUC) of 0.893 (95% CI, 0.881-0.904) and the best calibration with a calibration slope of 1.01. Complete case analysis is not a valuable option (AUC = 0.625).

conclusionsMachine learning techniques and traditional logistic regression exhibited comparable levels of predictive performance after handling the missingness. We suggest that the variables identified by this study may be good candidates for clinical prediction models to alert clinicians to the need for short-interval follow up and more intensive early therapy for HTN.

Indexed as

Antihypertensive AgentsElectronic Health RecordsHypertensionAdultAgedBlood PressureCohort StudiesDrug ResistanceFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk FactorsAntihypertensive Agentsapparent treatment resistant hypertensionelectronic health recordsmissing datapredictive factors

Identifiers

PMID39358502
PMCPMC12045898

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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.