Improving blood pressure for millions of Americans

The PCORnet Blood Pressure Control Laboratory is officially open for business.

Dr. Cooper-DeHoff
Dr. Cooper-DeHoff

A team led by Mark J. Pletcher, M.D., MPH and OneFlorida researcher Rhonda Cooper-DeHoff, Pharm.D., M.S., published a design and methods paper describing the laboratory and its operations in the March 2020 issue of Circulation.

The laboratory leverages PCORnet’s national network of clinics and electronic health record data, together with patient data collected directly from web- and mobile app-based patient portals to conduct national surveillance of blood pressure control, evaluate health care quality improvement efforts for blood pressure control, and facilitate pragmatic randomized clinical trials.

After the 2017 American College of Cardiology/American Heart Association Hypertension Guidelines lowered the blood pressure thresholds for diagnosis, treatment and control of hypertension, the prevalence of high blood pressure rose in the U.S. and now approaches 50% of all adults. Millions more Americans already being treated for hypertension are now considered to have uncontrolled blood pressure. Achieving optimal blood pressure control at the population level could save thousands of lives per year, according to the study authors.

The laboratory, a collaborative partnership between PCORnet, the American Medical Association (AMA) and the American Heart Association, currently hosts three demonstration projects, including

BP Track: This national blood pressure control surveillance system uses electronic health records to generate statistics on blood pressure control and blood pressure-related quality metrics for participating health care organizations. Already, BP Track has collected EHR data from more than 826,000 eligible patients with hypertension who completed about 3.1 million ambulatory visits.

BP MAP: This project will compare the effectiveness of a clinic-level hypertension quality improvement intervention that offers full support to patients, including on-site practice assessment, an in-person launch meeting, training and personalized support, with a digital version of the same intervention that is self-guided by the patients. BP MAP is based on the AMA’s 6-month M.A.P. Blood Pressure Improvement Program (Improving Blood Pressure Control in Diverse Populations by Measuring Accurately, Acting Rapidly, and Partnering with Patients).

BP Home: The PCORnet Blood Pressure Home Monitoring Study will compare the effectiveness of smartphone-linked versus standard home blood pressure monitors for helping patients with uncontrolled hypertension reduce their systolic blood pressure.

“Our goal is to provide results useful to our stakeholders, and to reuse the current PCORnet infrastructure for future efficient research that helps improve blood pressure control, reduce disparities, guide evidence-based use of technology, and improve cardiovascular outcomes for the U.S. population,” the researchers wrote.

The project was conceived by investigators and patients participating in the PCORnet Cardiovascular Health Collaborative Research Group, including OneFlorida, REACHnet, ADVANCE, and STAR; a Patient-Powered Research Network focused on cardiovascular health; an active patient advisory board; and the PCORnet Coordinating Center. The project received funding through PCORI’s Partnerships to Conduct Clinical Research within PCORnet Funding Announcement.

Investigators interested in using the laboratory’s resources should contact the study authors.

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