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Hypertension

Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson

Type
Disease or Syndrome
ID
PH575
Version ID
1150
Valid event data range
01/04/1997 - 31/03/2014
Sex
Female, Male
Agreement Date
2015-12-31
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

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).

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.

Publications

  • Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson, Renin-angiostensin system blockage and risk of acute kidney injury. 2015.

Clinical Code List

Rows: 130
Code Description Entity type Category Coding System (ICD-10 Read)
14A2.00 h/o: hypertension res30: Hypertension diagnostic Read
1JD..00 suspected hypertension res30: Hypertension diagnostic Read
2126100 hypertension resolved res30: Hypertension diagnostic Read
212K.00 hypertension resolved res30: Hypertension diagnostic Read
246M.00 white coat hypertension res30: Hypertension diagnostic Read
662..12 hypertension monitoring res30: Hypertension diagnostic Read
6624 borderline hyperten:yearly obs res30: Hypertension diagnostic Read
6627 good hypertension control res30: Hypertension diagnostic Read
6628 poor hypertension control res30: Hypertension diagnostic Read
6629 hypertension:follow-up default res30: Hypertension diagnostic Read
662F.00 hypertension treatm. started res30: Hypertension diagnostic Read
662G.00 hypertensive treatm.changed res30: Hypertension diagnostic Read
662H.00 hypertension treatm.stopped res30: Hypertension diagnostic Read
662O.00 on treatment for hypertension res30: Hypertension diagnostic Read
662P.00 hypertension monitoring res30: Hypertension diagnostic Read
662P000 hypertension 9 month review res30: Hypertension diagnostic Read
662b.00 moderate hypertension control res30: Hypertension diagnostic Read
662c.00 hypertension six month review res30: Hypertension diagnostic Read
662d.00 hypertension annual review res30: Hypertension diagnostic Read
662q.00 trial reduction of antihypertensive therapy res30: Hypertension diagnostic Read
662r.00 trial withdrawal of antihypertensive therapy res30: Hypertension diagnostic Read
67H8.00 lifestyle advice regarding hypertension res30: Hypertension diagnostic Read
7Q01.00 high cost hypertension drugs res30: Hypertension diagnostic Read
7Q01y00 other specified high cost hypertension drugs res30: Hypertension diagnostic Read
8B26.00 antihypertensive therapy res30: Hypertension diagnostic Read
8BL0.00 patient on maximal tolerated antihypertensive therapy res30: Hypertension diagnostic Read
8CR4.00 hypertension clinical management plan res30: Hypertension diagnostic Read
8HT5.00 referral to hypertension clinic res30: Hypertension diagnostic Read
8I3N.00 hypertension treatment refused res30: Hypertension diagnostic Read
9N03.00 seen in hypertension clinic res30: Hypertension diagnostic Read
9N1y200 seen in hypertension clinic res30: Hypertension diagnostic Read
9N4L.00 dna - did not attend hypertension clinic res30: Hypertension diagnostic Read
9OI..00 hypertension monitoring admin. res30: Hypertension diagnostic Read
9OI..11 hypertension clinic admin. res30: Hypertension diagnostic Read
9OI1.00 attends hypertension monitor. res30: Hypertension diagnostic Read
9OI2.00 refuses hypertension monitor. res30: Hypertension diagnostic Read
9OI3.00 hyperten.monitor offer default res30: Hypertension diagnostic Read
9OI4.00 hypertens.monitor.1st letter res30: Hypertension diagnostic Read
9OI5.00 hypertens.monitor 2nd letter res30: Hypertension diagnostic Read
9OI6.00 hypertens.monitor 3rd letter res30: Hypertension diagnostic Read
9OI7.00 hypertens.monitor verbal inv. res30: Hypertension diagnostic Read
9OI8.00 hypertens.monitor phone invite res30: Hypertension diagnostic Read
9OI9.00 hypertens.monitor deleted res30: Hypertension diagnostic Read
9OIA.00 hypertension monitor.chck done res30: Hypertension diagnostic Read
9OIA.11 hypertension monitored res30: Hypertension diagnostic Read
9OIZ.00 hypertens.monitoring admin.nos res30: Hypertension diagnostic Read
9h3..00 exception reporting: hypertension quality indicators res30: Hypertension diagnostic Read
9h31.00 excepted from hypertension qual indicators: patient unsuit res30: Hypertension diagnostic Read
9h32.00 excepted from hypertension qual indicators: informed dissent res30: Hypertension diagnostic Read
F404200 blind hypertensive eye res30: Hypertension diagnostic Read
F421300 hypertensive retinopathy res30: Hypertension diagnostic Read
G2...00 hypertensive disease res30: Hypertension diagnostic Read
G2...11 bp - hypertensive disease res30: Hypertension diagnostic Read
G20..00 essential hypertension res30: Hypertension diagnostic Read
G20..11 high blood pressure res30: Hypertension diagnostic Read
G20..12 primary hypertension res30: Hypertension diagnostic Read
G200.00 malignant essential hypertension res30: Hypertension diagnostic Read
G201.00 benign essential hypertension res30: Hypertension diagnostic Read
G202.00 systolic hypertension res30: Hypertension diagnostic Read
G203.00 diastolic hypertension res30: Hypertension diagnostic Read
G20z.00 essential hypertension nos res30: Hypertension diagnostic Read
G20z.11 hypertension nos res30: Hypertension diagnostic Read
G21..00 hypertensive heart disease res30: Hypertension diagnostic Read
G210.00 malignant hypertensive heart disease res30: Hypertension diagnostic Read
G210000 malignant hypertensive heart disease without ccf res30: Hypertension diagnostic Read
G210100 malignant hypertensive heart disease with ccf res30: Hypertension diagnostic Read
G210z00 malignant hypertensive heart disease nos res30: Hypertension diagnostic Read
G211.00 benign hypertensive heart disease res30: Hypertension diagnostic Read
G211000 benign hypertensive heart disease without ccf res30: Hypertension diagnostic Read
G211100 benign hypertensive heart disease with ccf res30: Hypertension diagnostic Read
G211z00 benign hypertensive heart disease nos res30: Hypertension diagnostic Read
G21z.00 hypertensive heart disease nos res30: Hypertension diagnostic Read
G21z000 hypertensive heart disease nos without ccf res30: Hypertension diagnostic Read
G21z011 cardiomegaly - hypertensive res30: Hypertension diagnostic Read
G21z100 hypertensive heart disease nos with ccf res30: Hypertension diagnostic Read
G21zz00 hypertensive heart disease nos res30: Hypertension diagnostic Read
G22..00 hypertensive renal disease res30: Hypertension diagnostic Read
G22..11 nephrosclerosis res30: Hypertension diagnostic Read
G220.00 malignant hypertensive renal disease res30: Hypertension diagnostic Read
G221.00 benign hypertensive renal disease res30: Hypertension diagnostic Read
G222.00 hypertensive renal disease with renal failure res30: Hypertension diagnostic Read
G22z.00 hypertensive renal disease nos res30: Hypertension diagnostic Read
G22z.11 renal hypertension res30: Hypertension diagnostic Read
G23..00 hypertensive heart and renal disease res30: Hypertension diagnostic Read
G230.00 malignant hypertensive heart and renal disease res30: Hypertension diagnostic Read
G231.00 benign hypertensive heart and renal disease res30: Hypertension diagnostic Read
G232.00 hypertensive heart&renal dis wth (congestive) heart failure res30: Hypertension diagnostic Read
G233.00 hypertensive heart and renal disease with renal failure res30: Hypertension diagnostic Read
G234.00 hyperten heart&renal dis+both(congestv)heart and renal fail res30: Hypertension diagnostic Read
G23z.00 hypertensive heart and renal disease nos res30: Hypertension diagnostic Read
G24..00 secondary hypertension res30: Hypertension diagnostic Read
G240.00 secondary malignant hypertension res30: Hypertension diagnostic Read
G240000 secondary malignant renovascular hypertension res30: Hypertension diagnostic Read
G240z00 secondary malignant hypertension nos res30: Hypertension diagnostic Read
G241.00 secondary benign hypertension res30: Hypertension diagnostic Read
G241000 secondary benign renovascular hypertension res30: Hypertension diagnostic Read
G241z00 secondary benign hypertension nos res30: Hypertension diagnostic Read
G244.00 hypertension secondary to endocrine disorders res30: Hypertension diagnostic Read
G24z.00 secondary hypertension nos res30: Hypertension diagnostic Read
G24z000 secondary renovascular hypertension nos res30: Hypertension diagnostic Read
G24z100 hypertension secondary to drug res30: Hypertension diagnostic Read
G24zz00 secondary hypertension nos res30: Hypertension diagnostic Read
G25..00 stage 1 hypertension (nice - nat ins for hth clin excl 2011) res30: Hypertension diagnostic Read
G25..11 stage 1 hypertension res30: Hypertension diagnostic Read
G26..00 severe hypertension (nat inst for health clinical ex 2011) res30: Hypertension diagnostic Read
G26..11 severe hypertension res30: Hypertension diagnostic Read
G27..00 hypertension resistant to drug therapy res30: Hypertension diagnostic Read
G28..00 stage 2 hypertension (nice - nat ins for hth clin excl 2011) res30: Hypertension diagnostic Read
G2y..00 other specified hypertensive disease res30: Hypertension diagnostic Read
G2z..00 hypertensive disease nos res30: Hypertension diagnostic Read
G672.00 hypertensive encephalopathy res30: Hypertension diagnostic Read
G672.11 hypertensive crisis res30: Hypertension diagnostic Read
Gyu2.00 [x]hypertensive diseases res30: Hypertension diagnostic Read
Gyu2000 [x]other secondary hypertension res30: Hypertension diagnostic Read
Gyu2100 [x]hypertension secondary to other renal disorders res30: Hypertension diagnostic Read
L122.00 other pre-existing hypertension in preg/childbirth/puerp res30: Hypertension diagnostic Read
L122000 other pre-existing hypertension in preg/childb/puerp unspec res30: Hypertension diagnostic Read
L122100 other pre-existing hypertension in preg/childb/puerp - deliv res30: Hypertension diagnostic Read
L122300 other pre-exist hypertension in preg/childb/puerp-not deliv res30: Hypertension diagnostic Read
L122z00 other pre-existing hypertension in preg/childb/puerp nos res30: Hypertension diagnostic Read
L127.00 pre-eclampsia or eclampsia with pre-existing hypertension res30: Hypertension diagnostic Read
L127z00 pre-eclampsia or eclampsia + pre-existing hypertension nos res30: Hypertension diagnostic Read
L128.00 pre-exist hypertension compl preg childbirth and puerperium res30: Hypertension diagnostic Read
L128000 pre-exist hyperten heart dis compl preg childbth+puerperium res30: Hypertension diagnostic Read
L128200 pre-exist 2ndry hypertens comp preg childbth and puerperium res30: Hypertension diagnostic Read
TJC7.00 adverse reaction to other antihypertensives res30: Hypertension diagnostic Read
TJC7z00 adverse reaction to antihypertensives nos res30: Hypertension diagnostic Read
U60C500 [x]oth antihyperten drug caus advers eff in therap use, nec res30: Hypertension diagnostic Read
U60C511 [x] adverse reaction to other antihypertensives res30: Hypertension diagnostic Read
U60C51A [x] adverse reaction to antihypertensives nos res30: Hypertension diagnostic Read
Rows: 19
Code Description Entity type Category Coding System (ICD-10 Read)
I10 essential (primary) hypertension res30: Hypertension diagnostic ICD-10
I11 hypertensive heart disease res30: Hypertension diagnostic ICD-10
I11.0 hypertensive heart disease with (congestive) heart failure res30: Hypertension diagnostic ICD-10
I11.9 hypertensive heart disease without (congestive) heart failure res30: Hypertension diagnostic ICD-10
I12 hypertensive renal disease res30: Hypertension diagnostic ICD-10
I12.0 hypertensive renal disease with renal failure res30: Hypertension diagnostic ICD-10
I12.9 hypertensive renal disease without renal failure res30: Hypertension diagnostic ICD-10
I13 hypertensive heart and renal disease res30: Hypertension diagnostic ICD-10
I13.0 hypertensive heart and renal disease with (congestive) heart failure res30: Hypertension diagnostic ICD-10
I13.1 hypertensive heart and renal disease with renal failure res30: Hypertension diagnostic ICD-10
I13.2 hypertensive heart and renal disease with both (congestive) heart failure and renal failure res30: Hypertension diagnostic ICD-10
I13.9 hypertensive heart and renal disease, unspecified res30: Hypertension diagnostic ICD-10
I15 secondary hypertension res30: Hypertension diagnostic ICD-10
I15.0 renovascular hypertension res30: Hypertension diagnostic ICD-10
I15.1 hypertension secondary to other renal disorders res30: Hypertension diagnostic ICD-10
I15.2 hypertension secondary to endocrine disorders res30: Hypertension diagnostic ICD-10
I15.8 other secondary hypertension res30: Hypertension diagnostic ICD-10
I15.9 secondary hypertension, unspecified res30: Hypertension diagnostic ICD-10
I67.4 hypertensive encephalopathy res30: Hypertension diagnostic ICD-10

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH575/version/1150/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH575/version/1150/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('PH575', '1150', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH575/version/1150/export/codes/?format=xml
JSON site_root/api/v1/public/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 = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH575', '1150', api_client=client)

Version History

Version
ID
Name Owner Publish date
1150 Hypertension ieuan.scanlon 2021-10-06 currently shown

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