Adherence to Recommended Laboratory Testing for Hypertension: Insights From A Nationwide Cohort

Maximilian C Volk; Ahmad Safdar; Omer Ashruf; Luke J Laffin

doi:10.1093/ajh/hpaf092

Adherence to Recommended Laboratory Testing for Hypertension: Insights From A Nationwide Cohort

Am J Hypertens. 2025 May 21:hpaf092. doi: 10.1093/ajh/hpaf092. Online ahead of print.

Authors

Maximilian C Volk¹, Ahmad Safdar¹, Omer Ashruf², Luke J Laffin³

Affiliations

¹ Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
² College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
³ Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.

PMID: 40394871
DOI: 10.1093/ajh/hpaf092

Abstract

Background: Despite guideline recommendations, the prevalence of laboratory testing among patients newly diagnosed with hypertension (HTN) in the United States remains unknown. This study evaluated the prevalence of guideline-recommended laboratory testing in patients with newly diagnosed HTN.

Methods: We conducted a retrospective analysis using the TriNetX database of adults ≥18 years newly diagnosed with HTN between 2018-2023. Patients were stratified by age, sex, race, and ethnicity. The primary outcome was prevalence of laboratory testing within six months of diagnosis, including complete blood count (CBC), basic/complete metabolic panel (BMP/CMP), lipid profile, thyroid-stimulating hormone (TSH), fasting glucose, urinalysis, and electrocardiogram (ECG).

Results: Among 2,052,702 patients (mean age 59.3 years, 47.3% female), testing completion rates were: CBC (40.8%), BMP/CMP (42.7%), lipid profile (17.0%), TSH (14.8%), fasting glucose (9.6%), urinalysis (21.9%), and ECG (36.3%). Older age (≥65 years) was associated with higher completion rates for CBC (HR 1.19, 95% CI 1.19-1.20), BMP/CMP (HR 1.16, 95% CI 1.16-1.17), TSH (HR 1.14, 95% CI 1.13-1.15), fasting glucose (HR 1.34, 95% CI 1.32-1.35), urinalysis (HR 1.19, 95% CI 1.18-1.20), and ECG (HR 1.27, 95% CI 1.26-1.28). Female sex was associated with lower rates for CBC (HR 0.99, 95% CI 0.98-0.99), BMP/CMP (HR 0.96, 95% CI 0.95-0.96), lipid profile (HR 0.90, 95% CI 0.89-0.90), ECG (HR 0.96, 95% CI 0.96-0.97) but higher for TSH (HR 1.26, 95% CI 1.25-2.17) and urinalysis (HR 1.13, 95% CI 1.12-1.14).

Conclusion: The prevalence of guideline-recommended laboratory testing among newly diagnosed HTN patients is low, with disparities across age, sex, race, and ethnicity.

Keywords: Age; Epidemiology; Ethnicity; Hypertension; Laboratory Testing; Race; Sex.

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