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Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Yuan Lu1,2, Cindy Xinxin Du2, Hazar Khidir3
1Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (Y.L., C.C., S.M., E.S.S., H.M.K.).
Circulation. Cardiovascular Quality and Outcomes
|February 2, 2023
Summary
Researchers developed a new way to classify patients with persistent hypertension using electronic health records. This taxonomy identifies reasons for uncontrolled blood pressure, enabling targeted interventions.
Area of Science:
- Cardiology
- Health Informatics
- Clinical Research
Background:
- Persistent hypertension management is evolving with digital health data.
- Electronic health records (EHRs) offer opportunities for novel patient stratification.
- Defining persistent hypertension requires consistent, high blood pressure readings over time.
Purpose of the Study:
- To create an actionable taxonomy for classifying patients with persistent hypertension.
- To leverage EHR data for stratifying patients based on hypertension persistence.
- To identify contributing factors to uncontrolled blood pressure in a patient cohort.
Main Methods:
- Qualitative content analysis of clinician notes within EHRs.
- Systematic, inductive approach to data abstraction and analysis.
- Analysis of 200 randomly selected patient records from 1664 eligible cases.
Main Results:
- Identified 3 domains contributing to hypertension persistence: non-intensification of treatment, non-implementation of prescribed treatment, and non-response to treatment.
- Saturation reached with 115 patients (mean age 66.0 years, 54.8% female).
- Patient demographics included White (52.2%), Black (30.4%), and Hispanic (13.9%) individuals.
Conclusions:
- A novel, actionable taxonomy for persistent hypertension classification was developed using EHR data.
- This taxonomy categorizes patients by the root causes of their uncontrolled blood pressure.
- The identified categories can be automated for targeted clinical interventions.
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