HealthDay News — A technology-based program may be used to identify patients with undiagnosed hypertension in the primary care setting, according to researchers.

“Hypertension affects 33% of all US adults aged 20 years and older; is the leading modifiable risk factor for coronary artery disease, stroke, congestive heart failure, and chronic kidney disease; and is associated with billions of dollars of costs related to medical care and lost productivity,” explained Michael K. Rokotz, MD, of Northwestern University in Chicago, and colleagues in the Annals of Family Medicine.

To help primary-care clinicians identify patients with undiagnosed hypertension, the researchers developed a technology-based strategy.

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An algorithm used to review electronic health records identified 1,432 patients with undiagnosed hypertension, the investigators reported. During the initial six-month period 475 of these patients completed a protocol for automated office blood pressure measurements. 

In phase two of the study, a quality improvement process included regular clinician feedback and office-based computer alerts to prompt evaluation of at-risk patients who had not been screened in phase one of the study.

Of the remaining 1,033 at-risk patients involved in phase two of the study, 740 patients (72%) were classified: 361 patients diagnosed with hypertension; 290 patients diagnosed with white-coat hypertension, prehypertension, or elevated blood pressure; and 89 patients diagnosed with normal blood pressure. By the end of the follow-up period, 293 patients (28%) remained unclassified and at risk for undiagnosed hypertension.

“This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients,” concluded the researchers.


  1. Rokotz M et al. Annals of Family Medicine. 2014; doi: 10.1370/afm.1665