TY - JOUR
T1 - Hypertension in Florida
T2 - Data from the one Florida clinical data research network
AU - Smith, Steven M.
AU - McAuliffe, Kathryn
AU - Hall, Jaclyn M.
AU - McDonough, Caitrin W.
AU - Gurka, Matthew J.
AU - Robinson, Temple O.
AU - Sacco, Ralph L.
AU - Pepine, Carl
AU - Shenkman, Elizabeth
AU - Cooper-DeHoff, Rhonda M.
N1 - Funding Information:
We thank Myrtle Graham, Janelle Johnson, and Carlos Maeztu, citizen scientists for OneFlorida, for their contributions to the OneFlorida hypertension working group and continued interest in hypertension. We thank Hongzhi Xu for providing statistical expertise in the analysis of these data. We also acknowledge Eileen Handberg, PhD, David R. Nelson, MD, and William R. Hogan, MD, MS, for their leadership roles in OneFlorida and review and input on this article. Research reported in this article was supported in part by the OneFlorida Clinical Data Network, funded by the Patient-Centered Outcomes Research Institute (no. CDRN-1501-26692); in part by the OneFlorida Cancer Control Alliance, funded by the Florida Department of Health’s James and Esther King Biomedical Research Program no. 4KB16; and in part by the University of Florida Clinical and Translational Science Institute and the University of Miami Clinical and Translational Science Institute, which are supported in part by the National Institutes of Health’s National Center for Advancing Translational Sciences under award nos. UL1TR001427 and UL1TR000460, respectively. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Patient- Centered Outcomes Research Institute, its board of governors or methodology, the OneFlorida Clinical Research Consortium, the University of Florida’s Clinical and Translational Science Institute, the Florida Department of Health, or the National Institutes of Health.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Introduction Hypertension is highly prevalent in Florida, but surveillance through the Behavioral Risk Factor Surveillance System (BRFSS) is limited to self-reported hypertension and does not capture data on undiagnosed hypertension or measure blood pressure. We aimed to characterize the hypertensive population in the OneFlorida Clinical Research Consortium by using electronic health records and provide proof-of-concept for using routinely collected clinical data to augment surveillance efforts. Methods We identified patients with hypertension, defined as having at least 1 outpatient visit from January 2012 through June 2016 with an ICD-9-CM or ICD-10-CM diagnosis code for hypertension, or in the absence of a diagnosis, an elevated blood pressure (systolic =140 mm Hg or diastolic =90 mm Hg) recorded in the electronic health record at the most recent visit. The hypertensive population was characterized and mapped by zip code of patient residence to county prevalence. Results Of 838,469 patients (27.9% prevalence) who met the criteria for hypertension, 68% had received a diagnosis and 61% had elevated blood pressure. The geographic distribution of hypertension differed between diagnosed hypertension (highest prevalence in northern Florida) and undiagnosed hypertension (highest prevalence along eastern coast, in southern Florida, and in some rural western Panhandle counties). Uncontrolled hypertension was concentrated in southern Florida and the western Panhandle. Conclusion Our use of clinical data, representing usual care for Floridians, allows for identifying cases of uncontrolled hypertension and potentially undiagnosed cases, which are not captured by existing surveillance methods. Large-scale pragmatic research networks, like OneFlorida, may be increasingly important for tailoring future health care services, trials, and public health programs.
AB - Introduction Hypertension is highly prevalent in Florida, but surveillance through the Behavioral Risk Factor Surveillance System (BRFSS) is limited to self-reported hypertension and does not capture data on undiagnosed hypertension or measure blood pressure. We aimed to characterize the hypertensive population in the OneFlorida Clinical Research Consortium by using electronic health records and provide proof-of-concept for using routinely collected clinical data to augment surveillance efforts. Methods We identified patients with hypertension, defined as having at least 1 outpatient visit from January 2012 through June 2016 with an ICD-9-CM or ICD-10-CM diagnosis code for hypertension, or in the absence of a diagnosis, an elevated blood pressure (systolic =140 mm Hg or diastolic =90 mm Hg) recorded in the electronic health record at the most recent visit. The hypertensive population was characterized and mapped by zip code of patient residence to county prevalence. Results Of 838,469 patients (27.9% prevalence) who met the criteria for hypertension, 68% had received a diagnosis and 61% had elevated blood pressure. The geographic distribution of hypertension differed between diagnosed hypertension (highest prevalence in northern Florida) and undiagnosed hypertension (highest prevalence along eastern coast, in southern Florida, and in some rural western Panhandle counties). Uncontrolled hypertension was concentrated in southern Florida and the western Panhandle. Conclusion Our use of clinical data, representing usual care for Floridians, allows for identifying cases of uncontrolled hypertension and potentially undiagnosed cases, which are not captured by existing surveillance methods. Large-scale pragmatic research networks, like OneFlorida, may be increasingly important for tailoring future health care services, trials, and public health programs.
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U2 - 10.5888/pcd15.170332
DO - 10.5888/pcd15.170332
M3 - Article
C2 - 29494332
AN - SCOPUS:85044297411
VL - 15
JO - Preventing chronic disease
JF - Preventing chronic disease
SN - 1545-1151
IS - 3
M1 - 170332
ER -