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Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017

BACKGROUND: Ambulatory blood pressure monitoring (ABPM) has been increasingly recommended for diagnosis confirmation and monitoring in patients with new-onset hypertension and apparent treatment-resistant hypertension (aTRH). We assessed insurance claims submitted for ABPM among a nationally represe...

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Autores principales: Desai, Raj, Park, Haesuk, Dietrich, Eric A., Smith, Steven M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803015/
https://www.ncbi.nlm.nih.gov/pubmed/33447762
http://dx.doi.org/10.1016/j.ijchy.2020.100033
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author Desai, Raj
Park, Haesuk
Dietrich, Eric A.
Smith, Steven M.
author_facet Desai, Raj
Park, Haesuk
Dietrich, Eric A.
Smith, Steven M.
author_sort Desai, Raj
collection PubMed
description BACKGROUND: Ambulatory blood pressure monitoring (ABPM) has been increasingly recommended for diagnosis confirmation and monitoring in patients with new-onset hypertension and apparent treatment-resistant hypertension (aTRH). We assessed insurance claims submitted for ABPM among a nationally representative sample of commercially insured U.S. patients. METHODS: We conducted a retrospective cross-sectional analysis using the IBM MarketScan® commercial claims database from January 2008–December 2017, including 2 populations: those with incident treated hypertension (ITH; first antihypertensive filled) or aTRH (first overlapping use of 4 antihypertensive agents). We identified ABPM claims filed within 6 months before to 6 months after the qualifying antihypertensive fill and determined prevalence of ABPM use overall and by year in each population. RESULTS: In total, 2,820,303 patients met ITH criteria and 298,049 met aTRH criteria. Of those with ITH, 7650 (2.7 per 1000 persons) had ≥1 ABPM claim submitted, and annual ABPM prevalence ranged from 2.0 to 3.7 per 1000 persons, increasing over time (P(trend)<0.0001). Among those with aTRH, 630 (2.1 per 1000 persons) had ≥1 ABPM claim submitted, and annual ABPM prevalence ranged from 1.6 to 2.7 per 1000 persons, decreasing over time (P(trend) = 0.054). Timing of ABPM claims suggested they were used primarily for diagnosis confirmation in ITH, and more evenly distributed between diagnosis confirmation and monitoring in aTRH. CONCLUSIONS: Despite guideline recommendations for more widescale use, ABPM appears to be used rarely in the U.S., with fewer than 0.5% of commercially insured patients with newly treated hypertension or aTRH having ABPM claims submitted to their insurance.
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spelling pubmed-78030152021-01-13 Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017 Desai, Raj Park, Haesuk Dietrich, Eric A. Smith, Steven M. Int J Cardiol Hypertens Research Paper BACKGROUND: Ambulatory blood pressure monitoring (ABPM) has been increasingly recommended for diagnosis confirmation and monitoring in patients with new-onset hypertension and apparent treatment-resistant hypertension (aTRH). We assessed insurance claims submitted for ABPM among a nationally representative sample of commercially insured U.S. patients. METHODS: We conducted a retrospective cross-sectional analysis using the IBM MarketScan® commercial claims database from January 2008–December 2017, including 2 populations: those with incident treated hypertension (ITH; first antihypertensive filled) or aTRH (first overlapping use of 4 antihypertensive agents). We identified ABPM claims filed within 6 months before to 6 months after the qualifying antihypertensive fill and determined prevalence of ABPM use overall and by year in each population. RESULTS: In total, 2,820,303 patients met ITH criteria and 298,049 met aTRH criteria. Of those with ITH, 7650 (2.7 per 1000 persons) had ≥1 ABPM claim submitted, and annual ABPM prevalence ranged from 2.0 to 3.7 per 1000 persons, increasing over time (P(trend)<0.0001). Among those with aTRH, 630 (2.1 per 1000 persons) had ≥1 ABPM claim submitted, and annual ABPM prevalence ranged from 1.6 to 2.7 per 1000 persons, decreasing over time (P(trend) = 0.054). Timing of ABPM claims suggested they were used primarily for diagnosis confirmation in ITH, and more evenly distributed between diagnosis confirmation and monitoring in aTRH. CONCLUSIONS: Despite guideline recommendations for more widescale use, ABPM appears to be used rarely in the U.S., with fewer than 0.5% of commercially insured patients with newly treated hypertension or aTRH having ABPM claims submitted to their insurance. Elsevier 2020-06-01 /pmc/articles/PMC7803015/ /pubmed/33447762 http://dx.doi.org/10.1016/j.ijchy.2020.100033 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Desai, Raj
Park, Haesuk
Dietrich, Eric A.
Smith, Steven M.
Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title_full Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title_fullStr Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title_full_unstemmed Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title_short Trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the U.S., 2008–2017
title_sort trends in ambulatory blood pressure monitoring use for confirmation or monitoring of hypertension and resistant hypertension among the commercially insured in the u.s., 2008–2017
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803015/
https://www.ncbi.nlm.nih.gov/pubmed/33447762
http://dx.doi.org/10.1016/j.ijchy.2020.100033
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