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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Nov;95(11):1048–1056.

Hypertension and medical informatics.

William McBride 1, Carlos Ferrario 1, Paulette A Lyle 1
PMCID: PMC2594689  PMID: 14651371

Abstract

BACKGROUND: Only about 27% of Americans with hypertension have their disease under control. Hypertension in the African-American population has a higher prevalence (32%) and is less likely to be treated or controlled compared with that in the caucasian population. Hypertension places a significant burden on patients and health care systems. Applications of medical informatics can facilitate the management of hypertension. Examples that illustrate the utility, status, and future potential of medical informatics applications in the treatment of hypertension are presented. METHODS: Relevant studies and review articles were accessed through a PubMed search of the English-language literature and for current Internet-based information for the time period of 1993-2002. Search terms included, but were not limited to, hypertension, medical informatics, medical information science, electronic medical records, Internet, and managed care. RESULTS: There is evidence that medical informatics has a favorable impact on health care issues as it relates to patients and physicians. Although the use of computers to assist in managing hypertension is in its infancy, there are examples where informatics applications have a demonstrated clinical value. CONCLUSIONS: Management of hypertension needs much improvement. The use of computers and the Internet in health care is expanding and expected to have a positive impact on the management of chronic diseases, such as hypertension.

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Selected References

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  1. Bates D. W. Using information technology to reduce rates of medication errors in hospitals. BMJ. 2000 Mar 18;320(7237):788–791. doi: 10.1136/bmj.320.7237.788. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bell D. S., Fonarow G. C., Hays R. D., Mangione C. M. Self-study from web-based and printed guideline materials. A randomized, controlled trial among resident physicians. Ann Intern Med. 2000 Jun 20;132(12):938–946. doi: 10.7326/0003-4819-132-12-200006200-00003. [DOI] [PubMed] [Google Scholar]
  3. Epstein R. S., Sherwood L. M. From outcomes research to disease management: a guide for the perplexed. Ann Intern Med. 1996 May 1;124(9):832–837. doi: 10.7326/0003-4819-124-9-199605010-00008. [DOI] [PubMed] [Google Scholar]
  4. Flack J. M., Mensah G. A., Ferrario C. M. Using angiotensin converting enzyme inhibitors in African-American hypertensives: a new approach to treating hypertension and preventing target-organ damage. Curr Med Res Opin. 2000;16(2):66–79. [PubMed] [Google Scholar]
  5. Friedman R. H., Kazis L. E., Jette A., Smith M. B., Stollerman J., Torgerson J., Carey K. A telecommunications system for monitoring and counseling patients with hypertension. Impact on medication adherence and blood pressure control. Am J Hypertens. 1996 Apr;9(4 Pt 1):285–292. doi: 10.1016/0895-7061(95)00353-3. [DOI] [PubMed] [Google Scholar]
  6. Goldstein M. K., Hoffman B. B., Coleman R. W., Musen M. A., Tu S. W., Advani A., Shankar R., O'Connor M. Implementing clinical practice guidelines while taking account of changing evidence: ATHENA DSS, an easily modifiable decision-support system for managing hypertension in primary care. Proc AMIA Symp. 2000:300–304. [PMC free article] [PubMed] [Google Scholar]
  7. Greenfield S., Rogers W., Mangotich M., Carney M. F., Tarlov A. R. Outcomes of patients with hypertension and non-insulin dependent diabetes mellitus treated by different systems and specialties. Results from the medical outcomes study. JAMA. 1995 Nov 8;274(18):1436–1444. [PubMed] [Google Scholar]
  8. Herzlinger R. The health care consumer gospel according to Harvard Business School: a talk with Regina Herzlinger, DBA. Interview by Richard L. Reece. Physician Exec. 2000 May-Jun;26(3):36–40. [PubMed] [Google Scholar]
  9. Hyman D. J., Pavlik V. N. Characteristics of patients with uncontrolled hypertension in the United States. N Engl J Med. 2001 Aug 16;345(7):479–486. doi: 10.1056/NEJMoa010273. [DOI] [PubMed] [Google Scholar]
  10. Johnson P. D., Tu S., Booth N., Sugden B., Purves I. N. Using scenarios in chronic disease management guidelines for primary care. Proc AMIA Symp. 2000:389–393. [PMC free article] [PubMed] [Google Scholar]
  11. Jones D., Basile J., Cushman W., Egan B., Ferrario C., Hill M., Lackland D., Mensah G., Moore M., Ofili E. Managing hypertension in the southeastern United States: applying the guidelines from the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Am J Med Sci. 1999 Dec;318(6):357–364. [PubMed] [Google Scholar]
  12. Kalsman M. W., Acosta D. A. Use of the Internet as a medical resource by rural physicians. J Am Board Fam Pract. 2000 Sep-Oct;13(5):349–352. [PubMed] [Google Scholar]
  13. Kassirer J. P. Patients, physicians, and the Internet. Health Aff (Millwood) 2000 Nov-Dec;19(6):115–123. doi: 10.1377/hlthaff.19.6.115. [DOI] [PubMed] [Google Scholar]
  14. Kleinke J. D. Vaporware.com: the failed promise of the health care Internet. Health Aff (Millwood) 2000 Nov-Dec;19(6):57–71. doi: 10.1377/hlthaff.19.6.57. [DOI] [PubMed] [Google Scholar]
  15. Montgomery A. A., Fahey T. A systematic review of the use of computers in the management of hypertension. J Epidemiol Community Health. 1998 Aug;52(8):520–525. doi: 10.1136/jech.52.8.520. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Nieto F. J., Alonso J., Chambless L. E., Zhong M., Ceraso M., Romm F. J., Cooper L., Folsom A. R., Szklo M. Population awareness and control of hypertension and hypercholesterolemia. The Atherosclerosis Risk in Communities study. Arch Intern Med. 1995 Apr 10;155(7):677–684. [PubMed] [Google Scholar]
  17. Ornstein S. M., Jenkins R. G. Quality of care for chronic illness in primary care: opportunity for improvement in process and outcome measures. Am J Manag Care. 1999 May;5(5):621–627. [PubMed] [Google Scholar]
  18. Perednia D. A., Allen A. Telemedicine technology and clinical applications. JAMA. 1995 Feb 8;273(6):483–488. [PubMed] [Google Scholar]
  19. Persson M., Mjörndal T., Carlberg B., Bohlin J., Lindholm L. H. Evaluation of a computer-based decision support system for treatment of hypertension with drugs: retrospective, nonintervention testing of cost and guideline adherence. J Intern Med. 2000 Jan;247(1):87–93. doi: 10.1046/j.1365-2796.2000.00581.x. [DOI] [PubMed] [Google Scholar]
  20. Shwartz M., Iezzoni L. I., Moskowitz M. A., Ash A. S., Sawitz E. The importance of comorbidities in explaining differences in patient costs. Med Care. 1996 Aug;34(8):767–782. doi: 10.1097/00005650-199608000-00005. [DOI] [PubMed] [Google Scholar]
  21. Sueta C. A., Chowdhury M., Boccuzzi S. J., Smith S. C., Jr, Alexander C. M., Londhe A., Lulla A., Simpson R. J., Jr Analysis of the degree of undertreatment of hyperlipidemia and congestive heart failure secondary to coronary artery disease. Am J Cardiol. 1999 May 1;83(9):1303–1307. doi: 10.1016/s0002-9149(99)00117-4. [DOI] [PubMed] [Google Scholar]
  22. Wager K. A., Lee F. W., White A. W., Ward D. M., Ornstein S. M. Impact of an electronic medical record system on community-based primary care practices. J Am Board Fam Pract. 2000 Sep-Oct;13(5):338–348. [PubMed] [Google Scholar]
  23. van der Lei J., van der Does E., Man in 't Veld A. J., Musen M. A., van Bemmel J. H. Response of general practitioners to computer-generated critiques of hypertension therapy. Methods Inf Med. 1993 Apr;32(2):146–153. [PubMed] [Google Scholar]

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