Phenotype Library | Phenotype: Hypertension

Overview

Phenotype Type
Disease or syndrome
Sex
Both
Valid Event Date Range
01/04/1997 - 31/03/2014
Coding System
ICD10 codesRead codes v2
Data Sources
CPRD GOLD, HES Admitted Patient Care data for CPRD GOLD
Collections
ClinicalCodes RepositoryPhenotype Library
Tags
No data
Definition

Objective:
To investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), and risk of acute kidney injury (AKI).
Design:
A time-updated, new-user cohort study among people initiating common antihypertensives (ACEI/ARB, beta-blockers, calcium channel blockers and thiazide diuretics) in primary care between April 1997 and March 2014.
Participants:
Adults initiating antihypertensive drug treatment, with at least one year of registration prior to first prescription, identified from UK primary care practices contributing to the Clinical Practice Research Datalink and eligible for linkage to hospital records data from the Hospital Episode Statistics database.
Main outcome measures:
Incidence rate ratio (RR) for first episode of AKI during time exposed to ACEI/ARB compared to time unexposed, estimated using Poisson regression adjusted for age, sex, comorbidities, use of other antihypertensive drugs, and calendar period.
Results:
Among 570,443 participants with a median follow-up of 2.8 years (IQR 0.4 to 7) there were 15,004 first cases of AKI. The overall crude rate of AKI was 6.4/1,000 person years at risk (95% CI 6.30 to 6.50) but varied from 1.63 (1.43 to 1.86) to 662.53 (538.98 to 814.40) depending on, age, comorbidities, and other prescribed drugs. The adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 1.18 (95% CI 1.13 to 1.23) which was attenuated to 1.12 (95% CI 1.08 to 1.17) after adjustment for non-thiazide diuretic therapy. There was an interaction for the risk of AKI between people using loop diuretics and ACEI/ARB. For those taking loop diuretics, the adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 0.99 (95% CI 0.92 to 1.06) but it was 1.18 (95% CI 1.13 to 1.24) among people not-exposed to loop diuretics (p<0 .001).< p>
Conclusions:

Treatment with ACEI/ARB alone appears to be associated with a small increase in the rate of AKI which is largely seen among people with low absolute risk of AKI. Among people requiring loop diuretics, who have a high absolute risk of AKI, treatment with ACEI/ARB had no measurable association with AKI.
Implementation

Implementation
No data
Clinical Code List
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PH575 / 1150 / C1978 - Hypertension - Primary Care | Read codes v2 | LEGACY VERSION
PUBLISHED - 130 Codes
LEGACY VERSION
Read codes v2
PH575 / 1150 / C1979 - Hypertension - Primary Care | ICD10 codes | LEGACY VERSION
PUBLISHED - 19 Codes
LEGACY VERSION
ICD10 codes
Publication
Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson, Renin-angiostensin system blockage and risk of acute kidney injury. 2015.
Citation Example
Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson. PH575 / 1150 - Hypertension. Phenotype Library [Online]. 06 October 2021. Available from: http://phenotypes.healthdatagateway.org/phenotypes/PH575/version/1150/detail/. [Accessed 03 October 2024]

API

To Export Phenotype Details:

Format	API
JSON	site_root/api/v1/phenotypes/PH575/version/1150/detail/?format=json
R Package	`# Download here library(ConceptLibraryClient) # Connect to API client = ConceptLibraryClient::Connection$new(public=TRUE) # Get details of phenotype phenotype_details = client$phenotypes$get_detail( 'PH575', version_id=1150 )`
Py Package	`# Download here from pyconceptlibraryclient import Client # Connect to API client = Client(public=True) # Get codelist of phenotype phenotype_codelist = client.phenotypes.get_detail( 'PH575', version_id=1150 )`

To Export Phenotype Code List:

Format	API
JSON	site_root/api/v1/phenotypes/PH575/version/1150/export/codes/?format=json
CSV	site_root/phenotypes/PH575/version/1150/export/codes/
R Package	`# Download here library(ConceptLibraryClient) # Connect to API client = ConceptLibraryClient::Connection$new(public=TRUE) # Get codelist of phenotype phenotype_codelist = client$phenotypes$get_codelist( 'PH575', version_id=1150 )`
Py Package	`# Download here from pyconceptlibraryclient import Client # Connect to API client = Client(public=True) # Get codelist of phenotype phenotype_codelist = client.phenotypes.get_codelist( 'PH575', version_id=1150 )`