FIVE-YEAR BLOOD PRESSURE TRAJECTORIES AND CUMULATIVE RISK OF SEVERELY UNCONTROLLED HYPERTENSION IN 67764 HYPERTENSIVE PATIENTS
Author(s)
Nir Y. Treves, PhD1, Mai Bernheim, PhD1, Adva Yarden, MD1, Roni Yahalom, DVM1, Victor Gross, MBA2, naomi rachel ben dor, MD2, Gabriel Chodick, PhD3, Galia Zacay, MPH, MD2.
1AstraZeneca, Kfar Saba, Israel, 2Meuhedet Health Services, Tel-Aviv, Israel, 3Tel Aviv University, Tel Aviv, Israel.
1AstraZeneca, Kfar Saba, Israel, 2Meuhedet Health Services, Tel-Aviv, Israel, 3Tel Aviv University, Tel Aviv, Israel.
OBJECTIVES: Despite effective antihypertensive therapies, many patients fail to achieve adequate blood pressure (BP) control, increasing cardiovascular and renal risk. As BP inherently fluctuates, understanding longitudinal control trajectories beyond a single assessment has important clinical implications. This study examined longitudinal BP control among hypertensive patients stratified by baseline control status.
METHODS: This retrospective cohort study utilized Meuhedet Health Services data to identify adults with hypertension and BP measurements between 2018 and 2024, obtained after ≥30 days of dual antihypertensive therapy. Patients were stratified into inadequately controlled (systolic BP (SBP)≥140 OR diastolic BP (DBP)≥90 mmHg) or controlled hypertension (SBP<140 AND DBP<90 mmHg) by index BP. Outcomes included: (1) proportion of measurements meeting inadequate control criteria by follow-up year; (2) proportion of patients with ≥1 inadequately controlled measurement per year; (3) SBP distribution at six-month intervals; (4) cumulative incidence of exceptionally uncontrolled hypertension (SBP ≥160, ≥170, ≥180 mmHg) over five years.
RESULTS: The study included 43,721 controlled and 24,043 inadequately controlled patients. Baseline classification maintained discriminatory capacity throughout follow-up. During year one, 50.9% of measurements in the inadequately controlled cohort met inadequate control criteria versus 24.0% in the controlled cohort, persisting throughout follow-up. Similarly, 73.0% vs. 43.6% of patients had ≥1 inadequately controlled measurement during year one. Median SBP remained elevated in the inadequately controlled cohort (~139 mmHg, IQR: 129-150) versus the controlled cohort (~128 mmHg, IQR: 120-138) across all intervals. Over five years, 33%, 22%, and 5% of the controlled cohort, and 58%, 35%, and 18% of the inadequately controlled cohort reached SBP ≥160, ≥170, and ≥180 mmHg.
CONCLUSIONS: Baseline BP control status in patients treated with two antihypertensive drugs durably predicts longitudinal control trajectories at the group level; however, individuals demonstrate substantial BP fluctuation, with even initially controlled patients experiencing.
METHODS: This retrospective cohort study utilized Meuhedet Health Services data to identify adults with hypertension and BP measurements between 2018 and 2024, obtained after ≥30 days of dual antihypertensive therapy. Patients were stratified into inadequately controlled (systolic BP (SBP)≥140 OR diastolic BP (DBP)≥90 mmHg) or controlled hypertension (SBP<140 AND DBP<90 mmHg) by index BP. Outcomes included: (1) proportion of measurements meeting inadequate control criteria by follow-up year; (2) proportion of patients with ≥1 inadequately controlled measurement per year; (3) SBP distribution at six-month intervals; (4) cumulative incidence of exceptionally uncontrolled hypertension (SBP ≥160, ≥170, ≥180 mmHg) over five years.
RESULTS: The study included 43,721 controlled and 24,043 inadequately controlled patients. Baseline classification maintained discriminatory capacity throughout follow-up. During year one, 50.9% of measurements in the inadequately controlled cohort met inadequate control criteria versus 24.0% in the controlled cohort, persisting throughout follow-up. Similarly, 73.0% vs. 43.6% of patients had ≥1 inadequately controlled measurement during year one. Median SBP remained elevated in the inadequately controlled cohort (~139 mmHg, IQR: 129-150) versus the controlled cohort (~128 mmHg, IQR: 120-138) across all intervals. Over five years, 33%, 22%, and 5% of the controlled cohort, and 58%, 35%, and 18% of the inadequately controlled cohort reached SBP ≥160, ≥170, and ≥180 mmHg.
CONCLUSIONS: Baseline BP control status in patients treated with two antihypertensive drugs durably predicts longitudinal control trajectories at the group level; however, individuals demonstrate substantial BP fluctuation, with even initially controlled patients experiencing.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH213
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)