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Phenotype Submission - Essential Hypertension

Researchers
#1

Cohort Definition Name: “Essential Hypertension”
Contributor name: Joel N. Swerdel
Contributor OrcId: 0000-0001-9491-2737
Logic Description: First occurrence of Essential Hypertension.
Recommended study application: outcome, indication
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
htn.txt (1.8 KB)

Target Clinical Description

Essential hypertension, also known as primary or idiopathic hypertension, is a chronic medical condition characterized by persistently elevated blood pressure levels without any identifiable cause. It is the most common form of hypertension, accounting for the majority of hypertension cases. Essential hypertension develops gradually over time and is influenced by a combination of genetic, lifestyle, and environmental factors. It is often referred to as the “silent killer” because it typically does not cause noticeable symptoms, but if left untreated, it can lead to serious complications such as heart disease, stroke, and kidney damage.

Presentation for essential hypertension:

  • High blood pressure readings: Consistently elevated blood pressure levels measured in millimeters of mercury (mmHg), typically defined as systolic blood pressure (top number) of 130 mmHg or higher and/or diastolic blood pressure (bottom number) of 80 mmHg or higher.

  • No specific symptoms: Essential hypertension is usually asymptomatic, with most individuals unaware of their condition until it is detected during a routine medical check-up or screening.

Assessment for essential hypertension:

  • Blood pressure measurement: Regular monitoring of blood pressure using a sphygmomanometer or automated blood pressure device.

  • Medical history: Evaluation of personal and family history of hypertension, cardiovascular diseases, or other risk factors.

  • Physical examination: Assessment of overall health status, including body weight, body mass index (BMI), and signs of organ damage related to hypertension.

  • Laboratory tests: Blood tests to assess kidney function, cholesterol levels, fasting blood glucose, and other parameters to evaluate overall cardiovascular health.

Differential diagnoses for essential hypertension:

  • Secondary hypertension: High blood pressure caused by an underlying medical condition such as kidney disease, hormonal disorders, or certain medications.

  • White coat hypertension: Temporary elevation of blood pressure in a medical setting due to anxiety or stress.

  • Masked hypertension: Normal blood pressure readings in a clinical setting but elevated blood pressure outside the clinic (e.g., at home or during daily activities).

Treatment plan for essential hypertension:

  • Lifestyle modifications: Encouraging healthy lifestyle choices, including regular exercise, a balanced diet (low in sodium, high in fruits and vegetables), weight management, smoking cessation, and stress reduction techniques.

  • Medications: Prescription medications may be recommended based on the individual’s blood pressure levels, overall health, and presence of other risk factors. Commonly prescribed medications include diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, and others.

  • Regular follow-up: Ongoing monitoring of blood pressure, adjustment of medications as needed, and periodic evaluation of target organ damage or associated conditions.

Prognosis for essential hypertension:

The prognosis for essential hypertension largely depends on the individual’s adherence to lifestyle modifications and treatment plans. With appropriate management, including lifestyle changes and medication adherence, blood pressure can be controlled, reducing the risk of complications. However, essential hypertension is a chronic condition that requires long-term monitoring and management. It is important for individuals with essential hypertension to work closely with healthcare providers to maintain healthy blood pressure levels, reduce the risk of complications, and improve overall cardiovascular health.

#2

Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 770 in the next release. Thank you ‘Joel Swerdel’,‘Eva-maria Didden’;

#3

Thanks @jswerdel for this submission. I plan to use it as I implement a nesting indication for hypertension drug cohort for HowOften.

A note to capture if for those interested: in the LEGEND-HTN study, to nest drug cohorts within the ‘hypertension’ indication, we used a conceptset of ‘Hypertensive disorder’ + descendants, which would also bring in terms like ‘benign hypertension’, ‘hypertensive urgency’, ‘pregnancy-induced hypertension’, and ‘secondary hypertension’. Joel’s definition here may be a bit more specific, though one could evaluate empirically if that makes a material difference.

1 Like
#4

I am unclear about benign hypertension, but the other terms that you pointed out - don’t appear semantically consistent with the idea of essential hypertension. As described by Joel above, the target is not any hypertension, but a subset of it.

#5

@jswerdel if you submit an evaluation for this definition, I think this cohort definition is well suited for peer review.

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