Study finds reason to test for high blood pressure outside of primary care
Expanding blood pressure screenings to non-primary care settings could help identify more patients with hypertension and result in improved control and management of the condition, according to a study published in the Journal of Clinical Hypertension.
Kaiser Permanente researchers analyzed the EHRs of about more than 1 million Kaiser Permanente Southern California patients who received treatment at primary care and non-primary care settings between January 2009 and March 2011. They examined how many cases of hypertension were identified among the patients and compared the characteristics of patients who were diagnosed with the condition in primary care settings versus non-primary care settings.
The study found that about 112,000 of the patients were diagnosed with high blood pressure by the end of the study period. Of those, 83 percent were diagnosed in a primary care setting and 17 percent were diagnosed in a non-primary care setting.
Of the patients diagnosed in non-primary care settings, the study found that 25 percent were diagnosed in ophthalmological care settings; 19 percent were diagnosed in neurological care settings; and 13 percent were diagnosed in dermatological care settings.
The rates of false positives for hypertension were similar among primary care and non-primary care settings, which the researchers said indicated that screenings were similarly accurate for both setting types.
Patients diagnosed with hypertension in non-primary care settings were more likely than those diagnosed in primary care settings to smoke and have chronic kidney disease and to be older, male and non-Hispanic white. In addition, researchers found that patients diagnosed in non-primary care settings were less likely to be obese.
"Patients who do not see their primary care providers on a regular basis may have hypertension that goes unrecognized. For this reason, expanding hypertension screening to non-primary care settings may be an opportunity to improve early hypertension recognition and control," according to the study's lead author Joel Handler.