{"doi":"10.1093/ajh/hpad078","title":"Prevalence and Correlates of Uncontrolled Hypertension, Persistently Uncontrolled Hypertension, and Hypertensive Crisis at a Healthcare System","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND</jats:title>\n                  <jats:p>Uncontrolled hypertension significantly increases risk of cardiovascular disease and death. This study examined the prevalence of uncontrolled hypertension, persistently uncontrolled hypertension, and hypertensive crisis and factors associated with these outcomes in a real-world patient cohort.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS</jats:title>\n                  <jats:p>Electronic medical records from a large healthcare system in North Carolina were used to identify adults with uncontrolled hypertension (last ambulatory blood pressure [BP] measurement ≥140/90); persistently uncontrolled hypertension (≥2 ambulatory BP measurements with all readings ≥140/90); and hypertensive crisis (any BP reading ≥180/120) in 2019. Generalized linear mixed models tested the association between patient and provider characteristics and each outcome.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS</jats:title>\n                  <jats:p>The study cohort included 213,836 patients (mean age 63.1 (±14.0) years, 55.5% female, 70.8% white). Of these, 29.7% and 13.1% had uncontrolled hypertension and hypertensive crisis, respectively. Among those experiencing hypertensive crisis, &amp;gt;50% did not have uncontrolled hypertension. Of the 171,061 patients with ≥2 BP measurements, 5.9% had persistently uncontrolled hypertension. The likelihood of uncontrolled hypertension, persistently uncontrolled hypertension, and hypertensive crisis was higher in patients with black race (vs. white), self-pay (vs. private), prior emergency room visit, and no attributed primary care provider. Readings taken in the evening (vs. morning) and at specialty (vs. primary care) practices were more likely to meet thresholds for uncontrolled hypertension and hypertensive crisis.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS</jats:title>\n                  <jats:p>Hypertension control remains a significant challenge in healthcare. Health systems may benefit from segmenting their patient population based on factors such as race, prior healthcare use, and timing of BP measurement to prioritize outreach and intervention.</jats:p>\n               </jats:sec>","journal":"American Journal of Hypertension","year":2023,"id":633728,"datarank":0.3958585994422889,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.0,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1643211,"name":"Allan Bond","orcid":null,"position":1,"is_corresponding":false},{"id":902789,"name":"Ryan Burns","orcid":"0000-0003-3545-8938","position":2,"is_corresponding":false},{"id":1643212,"name":"Yhenneko J Taylor","orcid":null,"position":3,"is_corresponding":false},{"id":602231,"name":"Andrew McWilliams","orcid":"0000-0003-3406-9201","position":4,"is_corresponding":false},{"id":1643214,"name":"John Schooley","orcid":null,"position":5,"is_corresponding":false},{"id":1643216,"name":"William B Applegate","orcid":null,"position":6,"is_corresponding":false},{"id":1643218,"name":"Gary Little","orcid":null,"position":7,"is_corresponding":false},{"id":1643210,"name":"Rohan Mahabaleshwarkar","orcid":"0000-0002-3165-4870","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Prevalence and Correlates of Uncontrolled Hypertension, Persistently Uncontrolled Hypertension, and Hypertensive Crisis at a Healthcare System","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND</jats:title>\n                  <jats:p>Uncontrolled hypertension significantly increases risk of cardiovascular disease and death. This study examined the prevalence of uncontrolled hypertension, persistently uncontrolled hypertension, and hypertensive crisis and factors associated with these outcomes in a real-world patient cohort.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS</jats:title>\n                  <jats:p>Electronic medical records from a large healthcare system in North Carolina were used to identify adults with uncontrolled hypertension (last ambulatory blood pressure [BP] measurement ≥140/90); persistently uncontrolled hypertension (≥2 ambulatory BP measurements with all readings ≥140/90); and hypertensive crisis (any BP reading ≥180/120) in 2019. Generalized linear mixed models tested the association between patient and provider characteristics and each outcome.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS</jats:title>\n                  <jats:p>The study cohort included 213,836 patients (mean age 63.1 (±14.0) years, 55.5% female, 70.8% white). Of these, 29.7% and 13.1% had uncontrolled hypertension and hypertensive crisis, respectively. Among those experiencing hypertensive crisis, &amp;gt;50% did not have uncontrolled hypertension. Of the 171,061 patients with ≥2 BP measurements, 5.9% had persistently uncontrolled hypertension. The likelihood of uncontrolled hypertension, persistently uncontrolled hypertension, and hypertensive crisis was higher in patients with black race (vs. white), self-pay (vs. private), prior emergency room visit, and no attributed primary care provider. Readings taken in the evening (vs. morning) and at specialty (vs. primary care) practices were more likely to meet thresholds for uncontrolled hypertension and hypertensive crisis.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS</jats:title>\n                  <jats:p>Hypertension control remains a significant challenge in healthcare. Health systems may benefit from segmenting their patient population based on factors such as race, prior healthcare use, and timing of BP measurement to prioritize outreach and intervention.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37639217","pmcid":null,"openalex_id":"https://openalex.org/W4386209795","authors":[],"funders":[],"total_grants":0,"fwci":1.9494,"citation_percentile":0.88222935,"influential_citations":0,"citation_trend":[{"year":2023,"count":1},{"year":2024,"count":3},{"year":2025,"count":4},{"year":2026,"count":3}],"oa_status":"bronze","license":"https://academic.oup.com/pages/standard-publication-reuse-rights","oa_locations":[{"url":"https://academic.oup.com/ajh/article-pdf/36/12/667/52524720/hpad078.pdf","host_type":"journal"},{"url":"https://academic.oup.com/ajh/article-pdf/36/12/667/52524720/hpad078.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/ajh/advance-article-pdf/doi/10.1093/ajh/hpad078/51718140/hpad078.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/ajh/hpad078","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37639217","host_type":"repository"}],"fields_of_study":["Blood Pressure and Hypertension Studies","Chronic Disease Management Strategies","Health Promotion and Cardiovascular Prevention","Adult","Humans","Female","Middle Aged","Male","Blood Pressure Monitoring, Ambulatory","Prevalence","Hypertension","Cardiovascular Diseases","Delivery of Health Care","Blood Pressure","Antihypertensive Agents"],"mesh_terms":["Adult","Antihypertensive Agents","Blood Pressure","Cardiovascular Diseases","Delivery of Health Care","Female","Humans","Hypertension","Male","Middle Aged","Prevalence","Blood Pressure Monitoring, Ambulatory"],"keywords":["Medicine","Hypertensive crisis","Blood pressure","Cardiology","Internal medicine","Healthcare system","Health care","Intensive care medicine","Hypertension","Blood Pressure Control","Health Disparities","Population Health","Real World","Healthcare Quality Measures"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T12:34:50.605366Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}