Characterizing apparent treatment resistant hypertension in the United States: insights from the All of Us Research Program.

IF 4.7 2区 医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS
Mona Alshahawey, Eissa Jafari, Steven M Smith, Caitrin W McDonough
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引用次数: 0

Abstract

Background: Hypertension (HTN) remains a significant public health concern and the primary modifiable risk factor for cardiovascular disease, which is the leading cause of death in the United States. We applied our validated HTN computable phenotypes within the All of Us Research Program to uncover prevalence and characteristics of HTN and apparent treatment-resistant hypertension (aTRH) in United States.

Methods: Within the All of Us Researcher Workbench, we built a retrospective cohort (January 1, 2008-July 1, 2023), identifying all adults with available age data, at least one blood pressure (BP) measurement, prescribed at least one antihypertensive medication, and with at least one SNOMED "Essential hypertension" diagnosis code.

Results: We identified 99 461 participants with HTN who met the eligibility criteria. Following the application of our computable phenotypes, an overall population of 81 462 were further categorized to aTRH (14.4%), stable-controlled HTN (SCH) (39.5%), and Other HTN (46.1%). Compared to participants with SCH, participants with aTRH were older, more likely to be of Black or African American race, had higher levels of social deprivation, and a heightened prevalence of comorbidities such as hyperlipidemia and diabetes. Heart failure, chronic kidney disease, and diabetes were the comorbidities most strongly associated with aTRH. β-blockers were the most prescribed antihypertensive medication. At index date, the overall BP control rate was 62%.

Discussion and conclusion: All of Us provides a unique opportunity to characterize HTN in the United States. Consistent findings from this study with our prior research highlight the interoperability of our computable phenotypes.

美国明显耐药性高血压的特征:"我们所有人 "研究计划的启示。
背景:高血压(HTN)仍然是一个重大的公共卫生问题,也是心血管疾病的主要可改变风险因素,而心血管疾病是美国人的主要死因。我们在 "我们所有人 "研究计划中应用了经过验证的高血压可计算表型,以揭示美国高血压和明显耐药高血压(aTRH)的患病率和特征:我们在 "我们所有人 "研究人员工作台(All of Us Researcher Workbench)中建立了一个回顾性队列(2008 年 1 月 1 日至 2023 年 7 月 1 日),识别了所有有年龄数据、至少测量过一次血压(BP)、至少服用过一种降压药、至少有一个 SNOMED "本质性高血压 "诊断代码的成年人:我们确定了 99 461 名符合资格标准的高血压患者。在应用我们的可计算表型后,81 462 名参与者被进一步划分为高血压患者(14.4%)、稳定控制型高血压(SCH)患者(39.5%)和其他高血压患者(46.1%)。与 SCH 患者相比,aTRH 患者年龄更大,更可能是黑人或非裔美国人,社会贫困程度更高,高脂血症和糖尿病等合并症的发病率更高。心力衰竭、慢性肾病和糖尿病是与 aTRH 关系最密切的合并症。β受体阻滞剂是最常用的降压药物。在指数日期,总体血压控制率为 62%:我们所有人》为了解美国高血压的特点提供了一个独特的机会。这项研究的结果与我们之前的研究结果一致,突出了我们可计算表型的互操作性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of the American Medical Informatics Association
Journal of the American Medical Informatics Association 医学-计算机:跨学科应用
CiteScore
14.50
自引率
7.80%
发文量
230
审稿时长
3-8 weeks
期刊介绍: JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
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