Adherence to Recommended Laboratory Testing for Hypertension: Insights from a Nationwide Cohort.

Background: Despite guideline recommendations, the prevalence of laboratory testing among patients newly diagnosed with hypertension (HTN) in the United States remains unknown. This study evaluated the prevalence of guideline-recommended laboratory testing in patients with newly diagnosed HTN.

Methods: We conducted a retrospective analysis using the TriNetX database of adults ≥18 years newly diagnosed with HTN between 2018 and 2023. Patients were stratified by age, sex, race, and ethnicity. The primary outcome was prevalence of laboratory testing within six months of diagnosis, including complete blood count (CBC), basic/complete metabolic panel (BMP/CMP), lipid profile, thyroid-stimulating hormone (TSH), fasting glucose, urinalysis, and electrocardiogram (ECG).

Results: Among 2,052,702 patients (mean age 59.3 years, 47.3% female), testing completion rates were: CBC (40.8%), BMP/CMP (42.7%), lipid profile (17.0%), TSH (14.8%), fasting glucose (9.6%), urinalysis (21.9%), and ECG (36.3%). Older age (≥65 years) was associated with higher completion rates for CBC (HR 1.19, 95% CI 1.19-1.20), BMP/CMP (HR 1.16, 95% CI 1.16-1.17), TSH (HR 1.14, 95% CI 1.13-1.15), fasting glucose (HR 1.34, 95% CI 1.32-1.35), urinalysis (HR 1.19, 95% CI 1.18-1.20), and ECG (HR 1.27, 95% CI 1.26-1.28). Female sex was associated with lower completion rates for CBC (HR 0.99, 95% CI 0.98-0.99), BMP/CMP (HR 0.96, 95% CI 0.95-0.96), lipid profile (HR 0.90, 95% CI 0.89-0.90), ECG (HR 0.96, 95% CI 0.96-0.97) but higher completion rates for TSH (HR 1.26, 95% CI 1.25-2.17) and urinalysis (HR 1.13, 95% CI 1.12-1.14).

Conclusions: The prevalence of guideline-recommended laboratory testing among newly diagnosed HTN patients is low, with disparities across age, sex, race, and ethnicity.