Abstract:
BACKGROUND:Inadequately treated hypertension (HTN) leads to considerable morbidity and mortality. Despite many treatment options, blood pressure (BP) control is suboptimal. Missed opportunities due to the growing complexity of primary care office visits contribute. Electronic health records (EHRs) offer best practice alerts (BPA) tools to support clinicians in identifying poor BP control. BPAs have demonstrated effectiveness for other health outcomes. METHODS:EHR data were collected for patients ≥18 years old seen for primary care office visits prior to, during, and after the BPA active period and used to identify patients for whom the BPA fired or would have fired during control periods. Logistic regression examined the association of BPA activation with follow-up BP check within 14-90 days and with BP control at follow-up, controlling for demographics and health conditions. RESULTS:The BPA active period was associated with reduced patient follow-up; however, a number of covariates were predictive of increased follow-up: Black non-Hispanics, Hispanics, patients on the chronic kidney disease, HTN, or diabetes registries, as well as the morbidly obese, insurance status, and seasonal factors. For those who did follow-up, BPA activation was associated with improved BP control. CONCLUSIONS:BPA activation was associated with worse patient follow-up but improved BP control. Some subgroups had significantly different rates of follow-up and BP control. This study did not have an experimental design as the BPA was a quality improvement initiative. These results highlight the critical importance of planning experimentally designed organizational initiatives to fully understand their impact.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Swedlund M,Norton D,Birstler J,Chen G,Cruz L,Hanrahan Ldoi
10.1093/ajh/hpy155subject
Has Abstractpub_date
2019-01-01 00:00:00pages
70-76issue
1eissn
0895-7061issn
1941-7225pii
5139654journal_volume
32pub_type
杂志文章abstract::Endothelin-1 is a potent vasoconstrictor peptide produced in blood vessels and other tissues that may play an important role in the control of local blood flow and could be involved in the pathogenesis of hypertension. Our previous studies have documented increases in endothelin-1 peptide content and gene expression i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)96213-4
更新日期:1995-03-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitors (ACEIs), introduced in clinical practice in 1980, are a relatively new class of drugs. They have been useful in the treatment of hypertension, where they are effective monotherapy in 40% to 50% of the patients and in combination therapy in up to 90%. They are also useful in the...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.1.57
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Most patients with hypertension require more than one agent to control blood pressure (BP). The purpose of this study was to assess the efficacy and safety of the angiotensin II receptor blocker olmesartan medoxomil in combination with hydrochlorothiazide (HCTZ). METHODS:This was a randomized, double-blind,...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2003.11.003
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:The target levels of home-monitored blood pressure (BP) in patients with type 2 diabetes mellitus (T2DM) have not yet been established. We sought to examine the appropriate target home BP level in T2DM. METHODS:This is a subanalysis of the Japan Morning Surge-Home Blood Pressure (J-HOP) study. We enrolled 4,...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu249
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Postural change in systolic blood pressure (SBP) is prospectively associated with several disease outcomes including hypertension, stroke, and coronary heart disease. The objective of this study was to characterize further a possible quantitative trait locus on chromosome 18q21 influencing SBP response to a ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.12.004
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:In the hypertensive heart, epicardial arteries are not enlarged, despite increased total coronary flow related to augmented cardiac workload, wall stress, and left ventricular (LV) mass. The aims of this study were to assess the impact of different hemodynamic factors and LV mass on baseline left main corona...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.07.003
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Aortic pulse wave velocity (PWV) is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end-stage renal disease receiving hemodialysis. Little data exist char...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.240
更新日期:2010-03-01 00:00:00
abstract::Serotonin-containing neurons in the central nervous system are grouped into a number of discrete and distinctive collections with cell bodies in the brainstem and projections passing to many regions of the brain and spinal cord. Evidence is presented that activation of one projection of serotonin-containing neurons fr...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/1.1.79
更新日期:1988-01-01 00:00:00
abstract::Angiotensin II (Ang II) and transforming growth factor-beta (TGF-beta) modulate cell growth and metabolism. Our objective was to evaluate the effect of Ang II on the characteristics and expression of TGF-beta receptors on vascular smooth muscle cells (VSMC) from Wistar-Kyoto rats. The addition of TGF-beta1 elicited a ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00152-1
更新日期:2000-02-01 00:00:00
abstract::Sodium ions markedly decreased in vitro renal alpha 2-adrenoceptor affinity for epinephrine in Sabra hypertensive (SBH) but not in normotensive (SBN) rats. Under these conditions, affinity of alpha 1-adrenoceptor for epinephrine was unchanged in SBH and SBN rats. If these data could be confirmed in vivo, the sodium io...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.3.267
更新日期:1991-03-01 00:00:00
abstract::To study potential ionic factors predisposing to vascular disease in hypertension, particularly among black subjects, we used a recently developed combined magnesium and calcium specific, ion selective electrode apparatus to measure extracellular ionized calcium (Ca-ion), ionized magnesium (Mg-ion), and Ca-ion/Mg-ion ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00364-6
更新日期:1997-12-01 00:00:00
abstract::Hypertension is a common condition that is often seen in patients with diabetes. Both diseases increase the risk of morbidity and mortality from CV events and kidney disease progression. Factors that influence blood pressure (BP) control in diabetes include the persons' genetic background for hypertension and kidney d...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa067
更新日期:2020-10-21 00:00:00
abstract:BACKGROUND:Hypertension is a risk factor for coronary heart disease (CHD), but the causes of hypertension remain largely unknown. Genetic variation is thought to contribute to the etiology of hypertension. We tested a single-nucleotide polymorphism (SNP) (Lys67Arg, rs197922) in the Golgi SNAP Receptor Complex Member 2 ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.336
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:We examined the associations of epithelial sodium channel (ENaC) genes with blood pressure (BP) changes and hypertension incidence in a longitudinal family study. METHODS:A total of 2,755 Han Chinese participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) baseline examination were eli...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu060
更新日期:2014-11-01 00:00:00
abstract::The role of renal sympathetic nerve activity (RSNA) in the maintenance phase of essential hypertension has not yet been clearly defined. Renal function and mean arterial pressure (MAP) were studied in four Yucatan miniature swine (YMS) with established DOCA hypertension prior to and for 3 weeks after surgical renal de...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.1.62
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Previous autopsy studies suggested that a reduced nephron number is associated with increased risk of hypertension and chronic kidney disease. However, the significance of the nephron number estimated from a renal biopsy in patients with hypertensive nephrosclerosis (HNS) has not yet been elucidated. METHOD...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu267
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Activation of RhoA/Rho kinase (ROK) pathway by angiotensin II (Ang II) is involved in the pathophysiology of hypertension and remodeling. In Bartter's and Gitelman's syndrome (BS/GS), the short-term and long-term signaling of Ang II are blunted. The BS/GS have also reduced expression and response on Ang II c...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.03.747
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Although previous studies have explored the effect of smoking on blood pressure, little is still known about the role of time to first cigarette (TTFC)-an indicator of nicotine dependence-in hypertension. Therefore, we evaluated this association using representative nationwide data. METHODS:Current daily sm...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy170
更新日期:2019-01-15 00:00:00
abstract::An intravenous glucose tolerance test (IVGTT) was performed on 16 spontaneously hypertensive rats (SHR) and 15 Wistar-Kyoto rats (WKY) by challenging them with an intravenous glucose load of 0.125 g/100 g body weight. Serum glucose and insulin were measured at 0, 15, 30, 60, 120, and 240 min. In a second experiment, o...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.8.661
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:The adipose tissue renin-angiotensin system (RAS) has been implicated in the pathophysiology of obesity and dysfunction of adipose tissue. However, neither regulation of angiotensinogen (AGT) expression in adipose tissue nor secretion of adipose tissue-derived AGT has been fully elucidated in humans. METHOD...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.263
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:B-type natriuretic peptide (BNP) increases the risk of death and cardiovascular events in patients without heart failure, even at BNP values within the "normal" range. The reasons for this are unclear. METHODS:We performed two separate studies (n = 33 and n = 129) on subjects with type 2 diabetes mellitus i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.06.016
更新日期:2005-12-01 00:00:00
abstract::Changes in the lipid composition of the membrane affect its fluidity and function. These variables are altered in various forms of hypertension. Our hypothesis was that the rapid increase in blood pressure (BP) caused by inhibition of nitric oxide production would lead to alterations in membrane fluidity similar to th...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01184-5
更新日期:2000-11-01 00:00:00
abstract::The stimulation of autocrine and paracrine factors such as basic fibroblast- (bFGF) and platelet-derived (PDGF) growth factors mediates many of the growth-promoting actions of angiotensin II. The aim of this study was to evaluate the effect of chronic AT1-receptor blockade on plasma endothelin-1 (ET-1) and growth fact...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00027-2
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The collateral circulation is important in maintenance of blood supply to the ischemic kidney distal to renal artery stenosis (RAS). Obesity metabolic syndrome (MetS) preserves renal blood flow (RBF) in the stenotic kidney, but whether this is related to an increase of collateral vessel growth is unknown. We...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy127
更新日期:2018-11-13 00:00:00
abstract::The renin content, expressed as nanograms of angiotensin I/hour/milligram, of a rabbit intrarenal arterial network (IAN) was compared to that of renal cortical samples from the same animal. Tissues from six rabbits were studied. Cortical tissue (RC) and an IAN with some glomeruli and attached arterioles (IAN + glomeru...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(94)00073-k
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to comprehensively test the associations of genetic variants of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-related genes with blood pressure (BP) responses to dietary sodium intervention in a Chinese population. METHODS:We conducted a 7-day low-sodium intervention ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw200
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:It is unknown whether the physiological impact of a given blood pressure (BP) varies by body size. We explored interactions between higher vs. lower systolic BP (SBP) targets and anthropometric measures (body mass index (BMI), body surface area (BSA), height, weight) and recurrent stroke and death in the Sec...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/hpu228
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Central artery reservoir-excess pressure parameters are clinically important but impractical to record directly. However, diastolic waveform morphology is consistent across central and peripheral arteries. Therefore, peripheral artery reservoir-excess pressure parameters related to diastolic waveform morphol...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa013
更新日期:2020-04-01 00:00:00
abstract::The results of 19 antihypertensive treatment trials spanning some 20 years of research showed that treatment had significant benefits for pressure-related complications of hypertension but generally did not prevent coronary artery disease morbidity or mortality. As possible reasons for this relative failure were explo...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,评审
doi:10.1093/ajh/2.12.313s
更新日期:1989-12-01 00:00:00
abstract::The peak incidence of cardiovascular complications in the morning points to a possible role of the abrupt increase in blood pressure on arising. However, there is as yet no firm evidence linking the extent of the elevation in blood pressure on arising and the risk of cardiovascular complications. We sought a correlati...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(96)00048-9
更新日期:1997-05-01 00:00:00