Hypertension is a major risk factor for stroke, cardiovascular disease, and end-stage renal disease, and its prevalence is expected to rise dramatically. Effective hypertension management is thus critical. A particular priority is decreasing the incidence of uncontrolled hypertension. Early identification of patients at risk for uncontrolled hypertension would allow targeted use of personalized, proactive treatments. We develop machine learning models (logistic regression and recurrent neural networks) to stratify patients with respect to the risk of exhibiting uncontrolled hypertension within the coming three-month period. We trained and tested models using EHR data from 14,407 and 3,009 patients, respectively. The best model achieved an AUROC of 0.719, outperforming the simple, competitive baseline of relying prediction based on the last BP measure alone (0.634). Perhaps surprisingly, recurrent neural networks did not outperform a simple logistic regression for this task, suggesting that linear models should be included as strong baselines for predictive tasks using EHR.
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Catheter Cardiovasc Interv
January 2025
Division of Cardiology, Ospedale degli Infermi, ASL, Biella, Italy.
Renal denervation is an emerging strategy for the management of uncontrolled hypertension. However, real-world experience is still modest, in particular for the management of complex anatomy, with available data being limited to the selected population of randomized clinical trials. We first describe the feasibility of delivering the renal denervation system to the target site with a child-in-mother technique, using a common coronary guiding extension, in a patient with severe tortuosity and double renal arteries.
View Article and Find Full Text PDFFront Public Health
January 2025
AstraZeneca SpA, Milano Innovation District (MIND), Milano, Italy.
Background: Software as a Medical Device (SaMD) and mobile health (mHealth) applications have revolutionized the healthcare landscape in the areas of remote patient monitoring (RPM) and digital therapeutics (DTx). These technological advancements offer a range of benefits, from improved patient engagement and real-time monitoring, to evidence-based personalized treatment plans, risk prediction, and enhanced clinical outcomes.
Objective: The systematic literature review aims to provide a comprehensive overview of the status of SaMD and mHealth apps, highlight the promising results, and discuss what is the potential of these technologies for improving health outcomes.
PLoS One
January 2025
Department of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Background: In 2019, 77% of women and 82% of men with hypertension had uncontrolled hypertension worldwide. Uncontrolled hypertension can cause stroke, myocardial infarction, heart failure, renal failure, dementia, blindness, and death. However, most of the studies used the previous seventh joint national committee classification to classify hypertensive patients as either controlled or uncontrolled.
View Article and Find Full Text PDFJ Clin Med
December 2024
Physio-Pathology and Immunology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
: With the development of artificial intelligence (A.I.), the optical coherence tomography angiography (OCTA) analysis of progression in hypertensive retinopathy could be improved.
View Article and Find Full Text PDFPatient Prefer Adherence
January 2025
Division of Hypertension, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Introduction: Self-care practices are crucial for optimizing blood pressure control and are influenced by multilevel factors.
Objective: To examine the influences of multilevel factors on hypertension self-care practices among individuals with uncontrolled hypertension and to determine the relationship between hypertension self-care practices and blood pressure.
Methods: The study was conducted in primary, secondary, and tertiary care settings in Bangkok, selected for convenience, where individuals with uncontrolled hypertension were recruited using a convenience sampling method based on specific inclusion criteria.
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