Year: 2023
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: We aimed to characterize seasonal variation in US population-based blood pressure (BP) control and BP-related metrics and evaluate the association between outdoor temperature and BP control variation. METHODS: We queried electronic health records (EHRs) from 26 health systems, representing 21 states, to summarize BP metrics by quarters of 12-month periods from January 2017 to March 2020. Patients with at least one ambulatory visit during the measurement period and a hypertension diagnosis during the first 6 months or prior to the measurement period were included. Changes in BP control, BP improvement, medication intensification, average SBP reduction after medication intensification across quarters and association with outdoor temperature were analyzed using weighted generalized linear models with repeated measures. RESULTS: Among 1 818 041 people with hypertension, the majority were more than 65 years of age (52.2%), female (52.1%), white non-Hispanic (69.8%) and had stage 1/2 hypertension (64.8%). Overall, BP control and process metrics were highest in quarters 2 and 3, and lowest in quarters 1 and 4. Quarter 2 had the highest percentage of improved BP (31.95 ± 0.90%) and average SBP reduction after medication intensification (16 ± 0.23 mmHg). Quarter 3 had the highest percentage of BP controlled (62.25 ± 2.55%) and lowest with medication intensification (9.73 ± 0.60%). Results were largely consistent in adjusted models. Average temperature was associated with BP control metrics in unadjusted models, but associations were attenuated following adjustment. CONCLUSION: In this large, national, EHR-based study, BP control and BP-related process metrics improved during spring/summer months, but outdoor temperature was not associated with performance following adjustment for potential confounders.
Source: Journal of Hypertension
Authors: Ester Kim Nilles, XiaoXia Champon, Hillary Mulder, Kathryn M. Shaw, Myra Smith, Zachary M. Lampron, Gregory Wozniak, Alanna M. Chamberlain, Thomas Carton, Anthony J. Viera, Faraz S. Ahmad, Benjamin A. Steinberg, Cynthia H. Chuang, Kathleen M. Mctigue, James C. McClay, Tamar S. Polonsky, Carlos Maeztu, Margaret Sanders, Nate Warren, Rajbir Singh, Mei Liu, Jeffrey J. VanWormer, Soo Park, Madelaine Faulkner Modrow, Michael Rakotz, Rhonda M. Cooper-Dehoff, Mark J. Pletcher, Emily C. O’Brien
Institutions: Duke University, Duke Clinical Research Institute, University of Florida Health, University of Florida, American Medical Association, Mayo Clinic, Tulane University, Louisiana Public Health Institute, Northwestern University, University of Utah, Pennsylvania State University, University of Pittsburgh, University of Nebraska at Omaha, University of Chicago, Ochin, Meharry Medical College, Marshfield Clinic Research Foundation, Marshfield Clinic Research Institute, University of California, San Francisco
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4323532004