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Hypertension

Evangelos Kontopantelis, Ivan Olier, Claire Planner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Sioban Reilly

Type
Disease or Syndrome
ID
PH533
Version ID
1066
Data Sources
Valid event data range
01/04/2000 - 31/03/2012
Sex
Female, Male
Agreement Date
2015-12-16
Coding system
Read codes v2 OXMIS codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

The database:

The CPRD is a large computerised database of anonymised primary care medical records. It contains complete patient information for participating practices, with the healthcare events (diagnoses, treatments, referrals, tests and prescriptions) recorded using coding systems (Read coding for diagnoses). Practice characteristics are described in detail elsewhere. The database is broadly representative of the UK population, although larger practices are over-represented. Practices need to meet prespecified data entry quality criteria to be defined as ‘up to research standard’, and for each study year, our main sample included all CPRD practices that were classed as such for the whole year. We also generated two data sets to test the sensitivity of our findings. First, we included all practices contributing data across the entire study period. Second, we included a subsample of 50 practices, representative of UK practices in terms of area deprivation, and practice list size.

Defining people with SMI and controls:

Information was extracted for the period 1 April 2000 to 31 March 2012 and aggregated into 12 yearly ‘bins’, to correspond with financial years 2000/2001–2011/2012. We used Read codes to identify the presence of SMI. First, we identified relevant keywords (or key-stubs) and codes, for example ‘paranoi’ and ‘E100.00’ (simple schizophrenia). Next, the CPRD was searched for codes that matched the list in either the code or the description field. Finally, the matched code list was reviewed by clinical experts and a final conservative list of codes was agreed. A similar process was used to define comorbidities (hypertension, asthma, hypothyroidism, osteoarthritis, chronic kidney disease, coronary heart disease, epilepsy, chronic obstructive pulmonary disease, cancer, stroke, heart failure, rheumatoid arthritis, dementia and psoriasis). All code lists we used are available from http://www.clinicalcodes.org. All conditions, bar asthma, were treated as unresolvable (ie, permanent). Within each year, all patients registered with a CPRD practice for the whole year and aged 18 or over were eligible for inclusion. The final SMI Read code list was used to identify cases of SMI, which were then grouped into three broad subcategories, in line with the diagnoses used when compiling primary care QOF SMI registers: schizophrenia; affective psychoses (bipolar disorder or other unspecified affective psychosis); other types of psychosis. In the event that an individual received more than one SMI diagnosis over the study period, we used the last available diagnosis to retrospectively ‘correct’ the original diagnosis (ie, we assumed that the latest diagnosis was the correct one). Within each year, each SMI case was then matched on age, sex and practice to five randomly selected patients not associated with SMI up until that time point. More details on the extraction of the cohort have been provided elsewhere,21 and a flow chart of the data extraction process is available in the online appendix figure A2.

Defining consultation type:

We defined a ‘consultation’ as involving direct contact between a patient and a healthcare professional within the primary care setting. We divided consultations into two main categories: face-to-face (our primary outcome), and by telephone (see online appendix table A1). We also constructed a third ‘other’ grouping of all other activities that are captured by the ‘consultation type’ codes within the CPRD. This includes mail/email contact, third party consultations (including referrals), secondary care episodes, other administrative tasks and consultations of unknown content. This group is highly heterogeneous and includes many activities that cannot be classed as consultations. However, we decided to use this grouping as an aggregate secondary outcome since it can potentially provide insight into the overall workload associated with patient care in the primary care context. We decided against breaking down the ‘other’ group in more subcategories as we are very doubtful regarding the reliability and across practice consistency of the coding within these ‘other’ categories. In instances where a patient had two or more consultations within a day, we conservatively assumed a single consultation took place, to reduce the likelihood of including duplicate records.

Publications

  • Evangelos Kontopantelis, Ivan Olier, Claire Panner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Siobhan Reilly, Primary care consultation rates among people with and without severe mental illness a UK cohort study using the Clinical Practice Research Datalink. BMJ Open, 5 (e008650), 2015.

Clinical Code List

Rows: 67
Code Description Entity type Coding System (OXMIS Read) Category
G2...00 Hypertensive disease res21: HT Read diagnostic
G2...11 BP - hypertensive disease res21: HT Read diagnostic
G20..00 Essential hypertension res21: HT Read diagnostic
G200.00 Malignant essential hypertension res21: HT Read diagnostic
G201.00 Benign essential hypertension res21: HT Read diagnostic
G202.00 Systolic hypertension res21: HT Read diagnostic
G20z.00 Essential hypertension NOS res21: HT Read diagnostic
G20z.11 Hypertension NOS res21: HT Read diagnostic
G21..00 Hypertensive heart disease res21: HT Read diagnostic
G210.00 Malignant hypertensive heart disease res21: HT Read diagnostic
G210000 Malignant hypertensive heart disease without CCF res21: HT Read diagnostic
G210100 Malignant hypertensive heart disease with CCF res21: HT Read diagnostic
G210z00 Malignant hypertensive heart disease NOS res21: HT Read diagnostic
G211.00 Benign hypertensive heart disease res21: HT Read diagnostic
G211000 Benign hypertensive heart disease without CCF res21: HT Read diagnostic
G211100 Benign hypertensive heart disease with CCF res21: HT Read diagnostic
G21z.00 Hypertensive heart disease NOS res21: HT Read diagnostic
G21z000 Hypertensive heart disease NOS without CCF res21: HT Read diagnostic
G21z011 Cardiomegaly - hypertensive res21: HT Read diagnostic
G21z100 Hypertensive heart disease NOS with CCF res21: HT Read diagnostic
G21zz00 Hypertensive heart disease NOS res21: HT Read diagnostic
G22..00 Hypertensive renal disease res21: HT Read diagnostic
G220.00 Malignant hypertensive renal disease res21: HT Read diagnostic
G221.00 Benign hypertensive renal disease res21: HT Read diagnostic
G222.00 Hypertensive renal disease with renal failure res21: HT Read diagnostic
G22z.00 Hypertensive renal disease NOS res21: HT Read diagnostic
G22z.11 Renal hypertension res21: HT Read diagnostic
G23..00 Hypertensive heart and renal disease res21: HT Read diagnostic
G230.00 Malignant hypertensive heart and renal disease res21: HT Read diagnostic
G231.00 Benign hypertensive heart and renal disease res21: HT Read diagnostic
G232.00 Hypertensive heart&renal dis wth (congestive) heart failure res21: HT Read diagnostic
G233.00 Hypertensive heart and renal disease with renal failure res21: HT Read diagnostic
G234.00 Hyperten heart&renal dis+both(congestv)heart and renal fail res21: HT Read diagnostic
G23z.00 Hypertensive heart and renal disease NOS res21: HT Read diagnostic
G24..00 Secondary hypertension res21: HT Read diagnostic
G240.00 Secondary malignant hypertension res21: HT Read diagnostic
G240000 Secondary malignant renovascular hypertension res21: HT Read diagnostic
G240z00 Secondary malignant hypertension NOS res21: HT Read diagnostic
G241.00 Secondary benign hypertension res21: HT Read diagnostic
G241000 Secondary benign renovascular hypertension res21: HT Read diagnostic
G241z00 Secondary benign hypertension NOS res21: HT Read diagnostic
G244.00 Hypertension secondary to endocrine disorders res21: HT Read diagnostic
G24z.00 Secondary hypertension NOS res21: HT Read diagnostic
G24z000 Secondary renovascular hypertension NOS res21: HT Read diagnostic
G24zz00 Secondary hypertension NOS res21: HT Read diagnostic
G2y..00 Other specified hypertensive disease res21: HT Read diagnostic
G2z..00 Hypertensive disease NOS res21: HT Read diagnostic
Gyu2000 [X]Other secondary hypertension res21: HT Read diagnostic
Gyu2100 [X]Hypertension secondary to other renal disorders res21: HT Read diagnostic
L120.00 Benign essential hypertension in pregnancy/childbirth/puerp res21: HT Read diagnostic
L120000 Benign essential hypertension in preg/childb/puerp unspec res21: HT Read diagnostic
L120100 Benign essential hypertension in preg/childb/puerp - deliv res21: HT Read diagnostic
L120300 Benign essential hypertension in preg/childb/puerp-not deliv res21: HT Read diagnostic
L120400 Benign essential hypertension in preg/childb/puerp +p/n comp res21: HT Read diagnostic
L120z00 Benign essential hypertension in preg/childb/puerp NOS res21: HT Read diagnostic
L121.00 Renal hypertension in pregnancy/childbirth/puerperium res21: HT Read diagnostic
L121000 Renal hypertension in pregnancy/childbirth/puerp unspecified res21: HT Read diagnostic
L121100 Renal hypertension in pregnancy/childbirth/puerp - delivered res21: HT Read diagnostic
L121300 Renal hypertension in preg/childbirth/puerp - not delivered res21: HT Read diagnostic
L121z00 Renal hypertension in pregnancy/childbirth/puerperium NOS res21: HT Read diagnostic
L122.00 Other pre-existing hypertension in preg/childbirth/puerp res21: HT Read diagnostic
L122000 Other pre-existing hypertension in preg/childb/puerp unspec res21: HT Read diagnostic
L122100 Other pre-existing hypertension in preg/childb/puerp - deliv res21: HT Read diagnostic
L122300 Other pre-exist hypertension in preg/childb/puerp-not deliv res21: HT Read diagnostic
L122z00 Other pre-existing hypertension in preg/childb/puerp NOS res21: HT Read diagnostic
L128.00 Pre-exist hypertension compl preg childbirth and puerperium res21: HT Read diagnostic
L128200 Pre-exist 2ndry hypertens comp preg childbth and puerperium res21: HT Read diagnostic
Rows: 52
Code Description Entity type Coding System (OXMIS Read) Category
3053HT NEUROGENIC HYPERTENSION (SECONDARY) res21: HT OXMIS diagnostic
4000 MALIGNANT HYPERTENSION res21: HT OXMIS diagnostic
4003 HYPERTENSIVE NEPHROPATHY res21: HT OXMIS diagnostic
4003AA HYPERTENSIVE RENAL DISEASE res21: HT OXMIS diagnostic
401 BENIGN HYPERTENSION res21: HT OXMIS diagnostic
401 A HYPERTENSION res21: HT OXMIS diagnostic
401 AC HYPERTENSION ACCELERATED res21: HT OXMIS diagnostic
401 AR HYPERTENSION ARTERIOSCLEROTIC res21: HT OXMIS diagnostic
401 AT HYPERTENSION ATHEROSCLEROTIC res21: HT OXMIS diagnostic
401 BM HYPERTENSION ON TREATMENT res21: HT OXMIS diagnostic
401 BN HYPERTENSION BENIGN res21: HT OXMIS diagnostic
401 C HYPERTENSION ESSENTIAL res21: HT OXMIS diagnostic
401 DC HYPERTENSION DIASTOLIC res21: HT OXMIS diagnostic
401 E HYPERTENSION ARTERIAL res21: HT OXMIS diagnostic
401 EL HYPERTENSION ARTERIAL SYSTEMIC res21: HT OXMIS diagnostic
401 LB HYPERTENSION LABILE INTERMITTENT res21: HT OXMIS diagnostic
401 P HYPERTENSION ARTERIAL PRIMARY res21: HT OXMIS diagnostic
401 PA HYPERTENSION PRIMARY res21: HT OXMIS diagnostic
401 S HYPERTENSION SYSTOLIC res21: HT OXMIS diagnostic
402 HYPERTENSIVE HEART DISEASE res21: HT OXMIS diagnostic
402 C HYPERTENSION CONGESTIVE HEART FAILURE res21: HT OXMIS diagnostic
402 MF MYOCARDIAL FIBROSIS WITH HYPERTENSION res21: HT OXMIS diagnostic
402 VH VENTRICULAR HYPERTROPHY HYPERTENSIVE res21: HT OXMIS diagnostic
403 RENAL HYPERTENSION res21: HT OXMIS diagnostic
403 AA RENAL HYPERTENSIVE DISEASE res21: HT OXMIS diagnostic
403 AH RENOVASCULAR HYPERTENSION res21: HT OXMIS diagnostic
403 NC HYPERTENSION IMPAIRED RENAL FUNCTION res21: HT OXMIS diagnostic
403 NF HYPERTENSION RENAL INSUFFICIENCY res21: HT OXMIS diagnostic
403 NG HYPERTENSIVE GLOMERULOSCLEROSIS res21: HT OXMIS diagnostic
4100N MYOCARDIAL INFARCT WITH HYPERTENSION res21: HT OXMIS diagnostic
4100NA MYOCARDIAL INFARCT ACUTE WITH HYPERTENSI res21: HT OXMIS diagnostic
4100T THROMBOSIS CORONARY WITH HYPERTENSION res21: HT OXMIS diagnostic
4120 INSUFFICIENCY CORONARY HYPERTENSIVE res21: HT OXMIS diagnostic
4120A ISCHAEMIC HEART DISEASE HYPERTENSIVE res21: HT OXMIS diagnostic
4120BD SYNDROME DRESSLER'S WITH HYPERTENSION res21: HT OXMIS diagnostic
4120CA CORONARY ARTERY DISEASE WITH HYPERTENSIO res21: HT OXMIS diagnostic
4120M MYOCARDIAL ISCHAEMIA WITH HYPERTENSION res21: HT OXMIS diagnostic
4130 ANGINA PECTORIS WITH HYPERTENSION res21: HT OXMIS diagnostic
4130E ANGINA EFFORT WITH HYPERTENSION res21: HT OXMIS diagnostic
4140 ASYMPTOMATIC HYPERTENSIVE ISCHAEMIC HEAR res21: HT OXMIS diagnostic
4300 SUBARACHNOID HAEMORRHAGE WITH HYPERTENSI res21: HT OXMIS diagnostic
4310 HAEMORRHAGE INTRACEREBRAL WITH HYPERTENS res21: HT OXMIS diagnostic
4330 CEREBRAL THROMBOSIS WITH HYPERTENSION res21: HT OXMIS diagnostic
4340 EMBOLISM CEREBRAL WITH HYPERTENSION res21: HT OXMIS diagnostic
4340CR EMBOLISM INTRACRANIAL WITH HYPERTENSION res21: HT OXMIS diagnostic
4360A CEREBROVASCULAR ACCIDENT WITH HYPERTENSI res21: HT OXMIS diagnostic
4360B STROKE WITH HYPERTENSION res21: HT OXMIS diagnostic
4360D HYPERTENSIVE ENCEPHALOPATHY res21: HT OXMIS diagnostic
4370 CEREBRAL ISCHAEMIA HYPERTENSIVE res21: HT OXMIS diagnostic
4380 CEREBROVASCULAR DISEASE WITH HYPERTENSIO res21: HT OXMIS diagnostic
4380HP HEMIPLEGIA WITH HYPERTENSION res21: HT OXMIS diagnostic
4419H HYPERTENSION ANEURYSM AORTA res21: HT OXMIS diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH533/version/1066/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH533/version/1066/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH533', '1066', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH533/version/1066/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH533/version/1066/export/codes/?format=json
CSV site_root/phenotypes/PH533/version/1066/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH533', '1066', api_client=client)

Version History

Version
ID
Name Owner Publish date
1066 Hypertension ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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