Wozniak Gregory, Khan Tamkeen, Gillespie Cathleen, Sifuentes Lori, Hasan Omar, Ritchey Matthew, Kmetik Karen, Wynia Matthew
American Medical Association, Chicago, IL.
Centers for Disease Control and Prevention, Atlanta, GA.
J Clin Hypertens (Greenwich). 2016 Mar;18(3):232-9. doi: 10.1111/jch.12654. Epub 2015 Sep 4.
Evidence-based interventions differ for increasing hypertension awareness, treatment, and control and should be targeted for specific patient panels. This study developed a hypertension control cascade to identify patients with a usual source of care represented at each level of the cascade using the 2007-2012 National Health and Nutrition Examination Survey. Overall, 10.7 million adults in the United States were unaware of their condition, 3.8 million were aware but untreated, and 15.8 million were treated but uncontrolled. The results also suggest that failure to attain hypertension control because of lack of awareness or lack of treatment despite awareness occurs mainly among younger individuals and those with no annual healthcare visits, while the elderly and minorities are more likely to remain uncontrolled when aware and treated. Opportunities to leverage population health management functions in electronic health information systems to align the specific patient subgroups facing barriers to hypertension control at each level of the cascade with targeted hypertension management interventions are discussed.
基于证据的干预措施在提高高血压知晓率、治疗率和控制率方面存在差异，应针对特定患者群体。本研究利用2007 - 2012年国家健康与营养检查调查，建立了一个高血压控制级联模型，以识别在该级联模型每个层面都有常规医疗服务来源的患者。总体而言，美国有1070万成年人不知道自己患有高血压，380万知晓但未接受治疗，1580万接受了治疗但未得到控制。结果还表明，由于缺乏知晓或虽知晓但未治疗而未能实现高血压控制的情况主要发生在年轻人和没有年度医疗就诊的人群中，而老年人和少数族裔在知晓并接受治疗的情况下更有可能仍未得到控制。文中讨论了利用电子健康信息系统中的人群健康管理功能，使在级联模型每个层面面临高血压控制障碍的特定患者亚组与有针对性的高血压管理干预措施相匹配的机会。
