Using electronic health record data for chronic disease surveillance in low- and middle-income countries: the example of hypertension in rural Guatemala

Hypertension is the leading preventable cause of death worldwide. Two-thirds of people with hypertension live in Low- and Middle-Income Countries (LMIC). However, epidemiological data necessary to address the growing burden of hypertension and other Non-Communicable Diseases (NCDs) in LMICs are severely lacking. Electronic Health Records (EHRs) are an emerging source of epidemiological data for LMICs, but have been underutilized for NCD monitoring. The objective of this study was to estimate the prevalence of hypertension in a rural Indigenous community in Guatemala using EHR data, describe hypertension risk factors and current treatment in this population, and demonstrate the feasibility of using EHR data for epidemiological surveillance of NCDs in LMIC. We conducted a cross-sectional analysis of 3646 adult clinic visits. We calculated hypertension prevalence using physician diagnosis, antihypertensive treatment, or Blood Pressure (BP) ≥140/90 mmHg. We noted antihypertensives prescribed and BP control (defined as BP