Journal article
Factors associated with discussing high blood pressure readings in clinical notes
American journal of hypertension, Vol.38(4), pp.225-232
03/17/2025
DOI: 10.1093/ajh/hpae153
PMCID: PMC11911316
PMID: 39661402
Abstract
Blood pressure (BP) is routinely measured and recorded at healthcare visits, but high BP (HBP) measurements are not always discussed in clinical notes. Our objective was to identify patient- and visit-level factors associated with discussion of HBP measurements in clinical notes, among patients without prior diagnosis of hypertension.
Data from 2016-2022 for all patients with any BP record of 140/90 mmHg or greater were obtained from University of Iowa Hospitals and Clinics electronic medical records. Patients with any prior hypertension diagnosis were excluded. We used a multi-level regression model to evaluate differences in the rates of discussing HBP. The model included varying intercepts for visit specialty and non-varying slopes and intercepts for patient- and visit-level features.
The final sample included 278,766 outpatient visits for 27,423 patients, of which 61,739 visits had HBP. Only 31% of visits with HBP had associated clinical notes with discussion of HBP. Even in primary-care-related clinics, HBP measurements were discussed in only 70% of visits. Factors associated with decreased odds of HBP being discussed in clinical notes included fever (OR: 0.46; 95%CI: 0.24-0.86) or external injury or pain (0.84; 0.79-0.90), and larger number of comorbidities (6+: 0.27; 0.22-0.32). Discussion of HBP in clinical notes was more likely among visits of patients with prior visits where HBP was discussed in clinical notes (12.36; 11.75-13.01).
We found that discussion of HBP is relatively uncommon. Increasing discussion of hypertension in clinical notes could decrease hypertension-related diagnostic inertia.
Details
- Title: Subtitle
- Factors associated with discussing high blood pressure readings in clinical notes
- Creators
- Cole G Chapman - University of IowaPhilip M Polgreen - University of IowaManish Suneja - University of IowaBarry L Carter - University of IowaLinnea A Polgreen - University of Iowa, Department of Pharmacy Practice and Science
- Resource Type
- Journal article
- Publication Details
- American journal of hypertension, Vol.38(4), pp.225-232
- DOI
- 10.1093/ajh/hpae153
- PMID
- 39661402
- PMCID
- PMC11911316
- NLM abbreviation
- Am J Hypertens
- ISSN
- 0895-7061
- eISSN
- 1941-7225
- Publisher
- Oxford Academic
- Grant note
- National Heart, Lung, and Blood Institute: HL144880 National Heart, Lung, and Blood Institute: UL1TR004403 National Center for Advancing Translational Science
This work was supported in part by a grant from the National Heart, Lung, and Blood Institute (#HL144880 to LAP) and the National Center for Advancing Translational Science (#UL1TR004403 to PMP). The content is solely the responsibility of the authors and does not necessarily represent the officieal views of the National Institutes of Health.
- Language
- English
- Electronic publication date
- 12/11/2024
- Date published
- 03/17/2025
- Academic Unit
- Infectious Diseases; Epidemiology; Pharmacy Practice and Science; Injury Prevention Research Center; Nephrology; Internal Medicine
- Record Identifier
- 9984757469002771
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