Athenahealth bullish on blood pressure

More than 60 percent of people over age 65 have high blood pressure
By Bernie Monegain
10:05 AM
Doctor looking at blood pressure screen

About 9 percent of patients who are over the age of 50 may be candidates for more aggressive treatment of hypertension, according to cloud-based EHR company athenahealth.

Athenahealth executives base the assertion on information obtained from the company's national network.

They point out that the results of the survey follows preliminary study findings made public last week by the National Institute of Health from the Systolic Blood Pressure Intervention Trial, or SPRINT.  Those findings suggest that lowering the systolic blood pressure guidelines from 140 and 150 to 120 could be lifesaving.

High blood pressure is a leading risk factor for a number of serious medical conditions, including stroke, heart failure and kidney disease. More than 60 percent of people over age 65 have high blood pressure, a number that is increasing. The SPRINT study was initiated in 2010 to determine whether lower recommended blood pressure targets might decrease incidences of stroke and heart disease; progression of chronic kidney disease; and age-related memory loss.

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Preliminary results concluded that patients assigned a SBP target below 120 -- far lower than current guidelines of 140, or 150 for people over 60 -- reduced their risk of heart attacks, heart failure and strokes by a third and their risk of death by nearly a quarter. These dramatic early results prompted the National Heart Lung and Blood Institute to stop the trial and announce the findings more than one year ahead of schedule.

Inspired by the NIH SPRINT study findings, researchers at athenahealth analyzed athenahealth's cloud-based national network of more than 67,000 healthcare providers and 69 million patients to estimate the potential impact that a blood pressure guideline change could have on U.S. physicians.

The analysis included more than 7.7 million patients over the age of 50 who had at least one visit with a provider between July 1, 2013 and June 30, 2015. athenahealth researchers estimate that 9 percent of individuals over 50 are identifiable through their EHR records as being candidates for intensive blood pressure management. 

The company is now developing tools that would allow physicians to identify these individuals and bring them in for further assessment.

"One of the benefits of athenahealth's intelligent platform for cloud-based clinical and practice management is that it allows us to see in near real-time the number of patients that may benefit from a groundbreaking study like SPRINT," said Josh Gray, vice president of athenaResearch at athenahealth, in a news release.

"Clinicians not only need to know the findings of seminal studies, but also to understand the potential impact on their patient panels. We are now in the process of developing functionality, which will make it easy for physicians to identify their patients who may benefit from more aggressive hypertension treatment and to contact those patients to suggest they come in for a visit," Gray added.

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As Gray sees it, with a potentially expanding range for what is considered appropriate for hypertension treatment, providers can expect an increase in patients who could benefit from more active management.

To help providers prepare, athenahealth can identify the population of candidate patients for more aggressive hypertension treatment and facilitate targeted outreach to set up appointments or make them aware of the new findings, he said.

athenahealth researchers believe the SPRINT study findings will increase care volume through more aggressive treatment of hypertension, accelerate the use of phone and other out-of-office communications to manage blood pressure levels, and provide opportunities for nurse practitioners and other professionals to work at the top of their licenses to manage patients with hypertension.