Expanding screening for hypertension to non-primary care settings could improve detection of hypertension and contribute to improved blood pressure management, according to research appearing in The Journal of Clinical Hypertension.
In the study, researchers at Kaiser Permanente evaluated the electronic health records of over one million patients that were seen over a two-year period in primary care setting and non-primary care, including optometry, orthopedics, and urology. The primary outcome was an initial blood pressure (BP) ≥140/90mmHg during a primary or non-primary care outpatient visit; a secondary outcome of BP follow-up within three months of the initial elevated BP was also assessed. All staff members performing the blood pressure screenings were certified in BP measurement for consistency in screenings.
Over 110,000 patients with hypertension were identified at the end of the two-year study (2009–2011). Eighty-three percent of patients were diagnosed with hypertension in a primary care setting; of the non-primary care settings, 25% were ophthalmology/optometry, 19% neurology, and 13% dermatology. Patients with hypertension identified in non-primary care settings tended to be older, male, non-Hispanic white, smoker, and have chronic kidney disease. They were also less likely to be obese vs. those identified in primary care settings. The proportion of patients with follow-up and “false positives” were comparable between both settings.
Due to the differences in patient characteristics between primary and non-primary care settings for hypertension screening, expanding this screening could help to identify patients that may not be diagnosed otherwise, the authors suggest.
For more information visit KaiserPermanente.org.