Hypertension prevalence in the All of Us Research Program among groups traditionally underrepresented in medical research
Authors: Chandler Paulette D. , Clark Cheryl R. , Zhou Guohai , Noel Nyia L. , Achilike Confidence , Mendez Lizette , Ramirez Andrea H. , Loperena-Cortes Roxana , Mayo Kelsey , Cohn Elizabeth , Ohno-Machado Lucila , Boerwinkle Eric , Cicek Mine , Qian Jun , Schully Sheri , Ratsimbazafy Francis , Mockrin Stephen , Gebo Kelly , Dedier Julien J. , Murphy Shawn N. , Smoller Jordan W. , Karlson Elizabeth W. ,   the All of Us Research Program Investigators, Ahsan Habibul , Ajayi Toluwalase , Alonso Alvaro , Arora Amit , Aschebrook-Kilfoy Briseis , Baxter Sally L. , Billheimer Dean , Bleeker Eugene R. , Bonomi Luca , Carrasquillo Olveen , Chen Qingxia , Chesla Dave , Craver Andrew , Dastur Zubin , Study/PRIDEnet The PRIDE , Ehiri John , Epstein Mara M. , Feng Xiaoke , Flentje Annesa , Project Alliance Health , Garber Lawrence , Giangreco Nicholas , Guo Yi , Hiatt Robert A. , Ho Kai Yin , Ho Joyce , Hogan William , Hripcsak George , Hunt Carolyn , Isai Rosario , Jiang Xinzhuo , Johnson Christine C. , Jordan King , Joseph Christine LM. , Kamel Hooman , Kames Jason H. , Keegan Theresa H. , Kim Karen , Kim Katherine K. , Kim Jihoon , King Paula , Klimentidis Yann C. , Kron Irving L. , Kuo Tsung-Ting , Lam Helen , Lash James P. , Lubensky Micah E. , Lunn Mitchell R. , Lussier Yves A. , McCauley Jacob L. , Meller Robert , Meyers Deborah A. , Montanex Valverde Raul A. , Vogel Julia L. Moore , Nagar Shashwat D. , Natarajan Kartnik , Obedin-Maliver Juno , Paul Paulina , Pawloski Pamela A. , Peltz-Rauchman Cathryn , Pemu Priscilla , Randal Fomessa T. , Rescate Ana , Ricardo Ana C. , Ross M. Elizabeth , Roth-Manning Brittney , Saranadasa Madhi , Shang Ning , Spencer Emily G. , Springer Cassie , Stevens Alan , Subbian Vignesh , Tang Amy , Trousdale Rhonda K. , Waalen Jill , Waring Stephen , Weng Chunhua , White Lisa , White Sonya , Wineinger Nathan E. , Yeh Chen , Yeh Hsueh-Han , Zakin Paul , Zhos Yanhua , Zuchner Stephan , Cronin Robert , Halvorson Alese , Ahmedani Brian 
Published: June 2021

The All of Us Research Program was designed to enable broad-based precision medicine research in a cohort of unprecedented scale and diversity. Hypertension (HTN) is a major public health concern. The validity of HTN data and definition of hypertension cases in the All of Us (AoU) Research Program for use in rule-based algorithms is unknown. In this cross-sectional, population-based study, we compare HTN prevalence in the AoU Research Program to HTN prevalence in the 2015–2016 National Health and Nutrition Examination Survey (NHANES). We used AoU baseline data from patient (age ≥ 18) measurements (PM), surveys, and electronic health record (EHR) blood pressure measurements. We retrospectively examined the prevalence of HTN in the EHR cohort using Systemized Nomenclature of Medicine (SNOMED) codes and blood pressure medications recorded in the EHR. We defined HTN as the participant having at least 2 HTN diagnosis/billing codes on separate dates in the EHR data AND at least one HTN medication. We calculated an age-standardized HTN prevalence according to the age distribution of the U.S. Census, using 3 groups (18–39, 40–59, and ≥ 60). Among the 185,770 participants enrolled in the AoU Cohort (mean age at enrollment = 51.2 years) available in a Researcher Workbench as of October 2019, EHR data was available for at least one SNOMED code from 112,805 participants, medications for 104,230 participants, and 103,490 participants had both medication and SNOMED data. The total number of persons with SNOMED codes on at least two distinct dates and at least one antihypertensive medication was 33,310 for a crude prevalence of HTN of 32.2%. AoU age-adjusted HTN prevalence was 27.9% using 3 groups compared to 29.6% in NHANES. The AoU cohort is a growing source of diverse longitudinal data to study hypertension nationwide and develop precision rule-based algorithms for use in hypertension treatment and prevention research. The prevalence of hypertension in this cohort is similar to that in prior population-based surveys.