Leveraging the Electronic Health Record to Identify and Manage Resistant Hypertension

Resistant hypertension (RH) affects more than a tenth of adults and yet remains relatively underrecognized and undertreated. The electronic health record (EHR) now stands as a critical tool for overcoming barriers to the diagnosis and treatment of RH, specifically with respect to aiding in detection, excluding alternate diagnoses, and guiding clinical decision making. We review how the EHR has clarified the population level prevalence of RH and its impact on both quality of life and longevity.

We examine how the EHR can be leveraged to identify relevant specific causes of elevated blood pressure such as medication non-adherence, clinical inertia, White Coat Effect, and hyperaldosteronism, among others. Additionally, we highlight the promises and potential pitfalls that warrant consideration when implementing novel EHR interventions to address clinical challenges such as RH. In particular, we discuss the importance of balancing augmented data availability with the need for streamlined data flow to clinicians, so that enhanced workflows can both maximize efficiency and improve quality of care. As the EHR continues to transform the practice of care delivery, RH represents a uniquely well-suited area for improving clinical identification and management in ways that could not be otherwise readily achieved in practice.