Predicting the Absence and Gaps in Recorded Blood Pressure Follow-up Among Patients With Hypertension

A gradient-boosted tree model predicts missing 90-day blood pressure follow-up after an elevated systolic reading in 30,942 adults with hypertension, with AUROC 0.740.

• Why it matters: Missing follow-up after high blood pressure readings limits timely reassessment, and outreach targeting may perform differently across racial and ethnic groups.
• What they did: Using MIMIC-IV, adults with hypertension and a first qualifying systolic reading >140 mmHg were modeled for absence of any recorded blood pressure within 90 days using 62 demographic, clinical, and contact-history features.
• The result: In the test set, the model selected the highest-risk 20% to capture 34.2% of patients without follow-up (PPV 60.4%), with sensitivity ranging from 21.5% in Black to 37.2% in White patients, and contact patterns adding minimal discrimination for cardiovascular hospitalization.

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