title: Screening for High Blood Pressure in Adults During Ambulatory Nonprimary Care Visits: Opportunities to Improve Hypertension Recognition.
abstract: Visits with nonprimary care providers such as optometrists may be missed opportunities for the detection of high blood pressure (BP). For this study, normotensive adults with at least 12 months of health plan membership on January 1, 2009 (n=1,075,522) were followed-up for high BP through March 14, 2011. Of 111,996 patients with a BP measurement ≥140/90 mm Hg, 82.7% were measured during primary care visits and 17.3% during nonprimary care visits. Individuals with a BP ≥140/90 mm Hg measured during nonprimary care visits were older and more likely to be male and non-Hispanic white. The proportion of patients with follow-up and false-positives were comparable between primary and nonprimary care. The main nonprimary care specialty to identify a first BP ≥140/90 mm Hg was ophthalmology/optometry with 24.5% of all patients. Results suggest that expanding screening for hypertension to nonprimary care settings may improve the detection of hypertension.
authors.affiliation: Kaiser Permanente Care Management Hypertension, Orange County Medical Center, Kaiser Permanente Southern California, Anaheim, CA.
authors.forename: Joel
authors.initials: J
authors.lastname: Handler
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Yasmina
authors.initials: Y
authors.lastname: Mohan
authors.affiliation: Quality and Clinical Analysis, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kanter
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Miki
authors.initials: M
authors.lastname: Nguyen
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Young
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Corinna
authors.initials: C
authors.lastname: Koebnick
mesh_terms: D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D001795:Blood Pressure Determination / Q000379:methods*; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011320:Primary Health Care; D012737:Sex Factors; D055815:Young Adult