Abstract

Introduction: Timely hypertension diagnosis is vital for effective management and prevention of complications. This study assessed hypertension diagnosis delays in a large regional health system using electronic health records (EHRs). Methods: Retrospective analysis of EHR data (2010-2021) in Sentara Healthcare System was conducted. Hypertension diagnosis was defined as two outpatient blood pressure (BP) readings >=140/90 mmHg within two years, with at least 30 days separation. The delay in diagnosis was determined as the time elapsed from the computable diagnosis to the structured diagnosis documented in the EHR. Results: Among 302,774 patients with computable hypertension diagnosis, 23.6% lacked a structured diagnosis. Furthermore, 23.8% received early structured diagnosis (after first BP elevation), and 18.6% received eventual structured diagnosis (after second BP elevation). Among those who received an eventual structured diagnosis, the median delay in hypertension diagnosis was 21.7 months (interquartile range: 7.5-45.5 months). Prescription rate for antihypertensive medication was significantly lower for patients with no structured diagnosis (44.2%) and eventual structured diagnosis (38.1%) than for those with early structured diagnosis (82.3%). Longer delays were associated with older age, male gender, and Black patients. Conclusions: The study highlights concerning delays in hypertension diagnosis, impacting timely intervention and complication prevention. By leveraging EHR data, health systems can identify areas for improvement and enhance the efficiency of hypertension diagnosis, leading to improved patient outcomes.

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