Hypertension in Florida: Data From the OneFlorida Clinical Data Research Network

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There were 10,659,174 unique patients in OneFlorida Data Trust as of June 30, 2016. Of these, 5,638,048 were excluded because they were aged <18 years. These exclusions left 5,021,126 adults aged ≥18 years with EHR data. Of these, 915,071 were excluded because they had no encounter during the study period. These exclusions left 4,106,055 adults with ≥1 encounter between January 1, 2012, and June 30, 2016. Of these, 1,096,000 were excluded because they had no ambulatory encounter during the study period. Of the 3,010,055 adults with ≥1 ambulatory visit or other ambulatory encounter, 570,664 had an ICD-9–based or ICD-10-CM–based hypertension diagnosis. Of these, 454,818 had ≥1 valid blood pressure recorded in the EHR and 115,846 had no valid blood pressure recorded in the EHR. Of the 3,010,055 adults with ≥1 ambulatory visit or other ambulatory encounter, no hypertension diagnosis was recorded for 2,439,391. Of these, 1,396,647 had ≥1 valid blood pressure recorded in the EHR and 1,042,744 had no valid blood pressure recorded in the EHR. Of those with no hypertension diagnosis recorded and ≥1 valid blood pressure recorded in the EHR, 267,805 had elevated blood pressure recorded in the EHR and 1,128,842 had no elevated blood pressure recorded in the EHR.

Figure 1.
Flow diagram for OneFlorida hypertensive cohort identification. Abbreviations: EHR, electronic health record; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification(11); ICD-10-CM, International Classification of Diseases, Tenth Revision, Clinical Modification(12).

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Figure 2.
Prevalence, by quintile, of hypertension among patients with at least 1 ambulatory visit or outpatient encounter recorded from January 1, 2012, through June 30, 2016, in OneFlorida, a partnership of 11 health systems and affiliated practices in Florida, by county. Panel A, prevalence of diagnosed hypertension; panel B, prevalence of hypertension, both diagnosed and undiagnosed; panel C, prevalence of elevated blood pressure but no hypertension diagnosis.

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Figure 3.
Prevalence, by quintile, of uncontrolled blood pressure (≥140/90 mm Hg) among hypertensive patients with at least 1 ambulatory visit or outpatient encounter recorded from January 1, 2012, through June 30, 2016, in OneFlorida, a partnership of 11 health systems and affiliated practices in Florida, by county. Panel A, prevalence of uncontrolled blood pressure, regardless of hypertension diagnosis; panel B, prevalence of uncontrolled blood pressure only among those with a hypertension diagnosis.

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