Abstract P350: Longitudinal And Summary Blood Pressure Measures And Clinical Decision-making Around Antihypertensive Therapeutic Intensification

Abstract

Background: The rate of treatment intensification (TI) emerges as the most important factor impacting BP control. BP has been consistently reported as the most potent clinical factor in deciding to intensify pharmacotherapy for hypertension. This study aims to quantify the relationship between measured BP and variance in therapeutic intensification (TI). Methods: Data for defining and modeling antihypertensive TI comes from ambulatory primary care clinics at five distinct health care organizations. Mixed-effects logistic regression was used to model longitudinal BP related information and antihypertensive TI at visits with uncontrolled BP (≥140/≥90 mmHg). Results: TI increased as a function of progressively higher SBP (Table 1) and DBP for both current and previous visit BP values. Yet, current and prior visit BP accounted for only 2.8% and 0.8%, respectively, of the variance in TI. Conclusion: Current and historical BP values impact TI. While BP is the most important factor influencing TI, its impact is limited. Highly efficient point-of-care access to previous BP might improve the rate of TI. Yet, there are potent factors limiting TI which require attention.