CALIBER Blood pressure phenotype

person Phenotype Systolic/Diastolic blood pressure
person Type Biomarker
person Data sources Primary care (CPRD)
person Clinical Terminologies Read
person Valid event date range 01/01/1999 - 01/07/2016
person Sex Female/Male
person Agreed 23.11.2012 (Revision 2)
person Authors Julie George, Emily Herrett, Liam Smeeth, Harry Hemingway, Anoop Shah, Spiros Denaxas

Primary Care

In the Clinical Practice Research Datalink (CPRD, primary care data) we extracted systolic and diastolic blood pressure measurements using the structured data component of the additional CPRD table (entity type 1). Diastolic measurements were extracted from the data2 field and diastolic measurements from the data1 field.

We additionally extracted clinician-assigned blood pressure measurement characteristics based on Read terms (see below).

Read codeRead termCALIBER category
246..00 O/E - blood pressure reading Ordinary blood pressure measurement
246..11 O/E - BP reading Ordinary blood pressure measurement
246..12 O/E - blood pressure Ordinary blood pressure measurement
2460.00 O/E - BP unrecordable Ordinary blood pressure measurement
2461.00 O/E - BP reading very low Ordinary blood pressure measurement
2462.00 O/E - BP reading low Ordinary blood pressure measurement
2463.00 O/E - BP borderline low Ordinary blood pressure measurement
2464.00 O/E - BP reading normal Ordinary blood pressure measurement
2465.00 O/E - BP borderline raised Ordinary blood pressure measurement
2466.00 O/E - BP reading raised Ordinary blood pressure measurement
2467.00 O/E - BP reading very high Ordinary blood pressure measurement
2468.00 O/E - BP reading:postural drop Ordinary blood pressure measurement
2469.00 O/E - Systolic BP reading Ordinary blood pressure measurement
246A.00 O/E - Diastolic BP reading Ordinary blood pressure measurement
246B.00 O/E - BP stable Ordinary blood pressure measurement
246C.00 Lying blood pressure reading Ordinary blood pressure measurement
246D.00 Standing blood pressure reading Ordinary blood pressure measurement
246E.00 Sitting blood pressure reading Ordinary blood pressure measurement
246F.00 O/E - blood pressure decreased Ordinary blood pressure measurement
246G.00 O/E - BP labile Ordinary blood pressure measurement
246J.00 O/E - BP reading: no postural drop Ordinary blood pressure measurement
246N.00 Standing systolic blood pressure Ordinary blood pressure measurement
246P.00 Standing diastolic blood pressure Ordinary blood pressure measurement
246Q.00 Sitting systolic blood pressure Ordinary blood pressure measurement
246R.00 Sitting diastolic blood pressure Ordinary blood pressure measurement
246S.00 Lying systolic blood pressure Ordinary blood pressure measurement
246T.00 Lying diastolic blood pressure Ordinary blood pressure measurement
246Z.00 O/E-blood pressure reading NOS Ordinary blood pressure measurement
6623.00 Pre-treatment BP reading Ordinary blood pressure measurement
662B.00 O/E - initial high BP Ordinary blood pressure measurement
662C.00 O/E - check high BP Ordinary blood pressure measurement
662Q.00 Borderline blood pressure Ordinary blood pressure measurement
662V.00 Blood pressure monitoring Ordinary blood pressure measurement
68B1.00 Hypertension screen Ordinary blood pressure measurement
9OD..11 BP screen administration Ordinary blood pressure measurement
9OD..12 Blood pressure screen admin Ordinary blood pressure measurement
9OD1.00 BP screen - 1st call Ordinary blood pressure measurement
9OD2.00 BP screen - 2nd call Ordinary blood pressure measurement
9OD3.00 BP screen - 3rd call Ordinary blood pressure measurement
9OD5.00 BP screen - 1st recall Ordinary blood pressure measurement
9OD6.00 BP screen - 2nd recall Ordinary blood pressure measurement
9OD7.00 BP screen - 3rd recall Ordinary blood pressure measurement
9OD9.00 BP ABNORMAL - 1st recall Ordinary blood pressure measurement
9ODA.00 BP ABNORMAL - 2nd recall Ordinary blood pressure measurement
9ODB.00 BP ABNORMAL - 3rd recall Ordinary blood pressure measurement
G2...11 BP - hypertensive disease Ordinary blood pressure measurement
G20..11 High blood pressure Ordinary blood pressure measurement
R1y2.00 [D]Raised blood pressure reading Ordinary blood pressure measurement
R1y3.00 [D]Low blood pressure reading Ordinary blood pressure measurement
R1y4.00 [D]BP reading labile Ordinary blood pressure measurement
ZV70B00 [V]Examination of blood pressure Ordinary blood pressure measurement
246c.00 Average home diastolic blood pressure Home blood pressure measurement
246d.00 Average home systolic blood pressure Home blood pressure measurement
246g.00 Self measured blood pressure reading Home blood pressure measurement
662j.00 Blood pressure recorded by patient at home Home blood pressure measurement
246V.00 Average 24 hour diastolic blood pressure Ambulatory blood pressure measurement
246W.00 Average 24 hour systolic blood pressure Ambulatory blood pressure measurement
246X.00 Average day interval diastolic blood pressure Ambulatory blood pressure measurement
246Y.00 Average day interval systolic blood pressure Ambulatory blood pressure measurement
246a.00 Average night interval diastolic blood pressure Ambulatory blood pressure measurement
246b.00 Average night interval systolic blood pressure Ambulatory blood pressure measurement
246e.00 Ambulatory systolic blood pressure Ambulatory blood pressure measurement
246f.00 Ambulatory diastolic blood pressure Ambulatory blood pressure measurement
315B.00 Ambulatory blood pressure recording Ambulatory blood pressure measurement
662L.00 24 hr blood pressure monitoring Ambulatory blood pressure measurement
246K.00 Target systolic blood pressure Target blood pressure measurement
246L.00 Target diastolic blood pressure Target blood pressure measurement
Read terms are hierarhically organized in top-level chapters i.e. chapter G....00 is related to Circulatory System Diseases and sub-headings i.e. heading G2...00 is related to Hypertensive Heart Disease while G3...00 is related to Ischaemic Heart Disease.
Not applicable.
Not applicable.

Combining evidence across sources to define and date phenotypes

Where multiple measurements were present in a single consultation (identified by the consid identifier) we calculated the average. We defined the range of plausible values as 20-350 mmHg for systolic measurements and 20-200 mmHg for diastolic measurements.
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Gho JMIH et al. An electronic health records cohort study on heart failure following myocardial infarction in England: incidence and predictors. BMJ Open. 2018 Mar 3;8(3):e018331. doi: 10.1136/bmjopen-2017-018331. PMID: 29502083


Steele AJ et al. Machine learning models in electronic health records can outperform conventional survival models for predicting patient mortality in coronary artery disease. PLoS One. 2018 Aug 31;13(8):e0202344. doi: 10.1371/journal.pone.0202344. eCollection 2018. PMID: 30169498


Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2. PMID: 29966429


Koudstaal S et al. Prognostic burden of heart failure recorded in primary care, acute hospital admissions, or both: a population-based linked electronic health record cohort study in 2.1 million people. Eur J Heart Fail. 2017 Sep;19(9):1119-1127. doi: 10.1002/ejhf.709. Epub 2016 Dec 23. PMID: 28008698


Chung SC et al. Time spent at blood pressure target and the risk of death and cardiovascular diseases. PLoS One. 2018 Sep 5;13(9):e0202359. doi: 10.1371/journal.pone.0202359. eCollection 2018. PMID: 30183734


Bell S et al. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. PMID: 28331015


Pasea L et al. Personalising the decision for prolonged dual antiplatelet therapy: development, validation and potential impact of prognostic models for cardiovascular events and bleeding in myocardial infarction survivors. Eur Heart J. 2017 Apr 7;38(14):1048-1055. doi: 10.1093/eurheartj/ehw683. PMID: 28329300


Shah AD et al. Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022. PMID: 28254179


Asaria M et al. Using electronic health records to predict costs and outcomes in stable coronary artery disease. Heart. 2016 May 15;102(10):755-62. doi: 10.1136/heartjnl-2015-308850. Epub 2016 Feb 10. PMID: 26864674


Daskalopoulou M et al. Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016. PMID: 27105076


Pujades-Rodriguez M et al. Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19. PMID: 26786818


Pujades-Rodriguez M et al. Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245. eCollection 2016. PMID: 26978266


Shah AD et al. Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016. PMID: 27621833


Timmis A et al. Prolonged dual antiplatelet therapy in stable coronary disease: comparative observational study of benefits and harms in unselected versus trial populations. BMJ. 2016 Jun 22;353:i3163. PMID: 27334486


Walker S et al. Long-term healthcare use and costs in patients with stable coronary artery disease: a population-based cohort using linked health records (CALIBER). Eur Heart J Qual Care Clin Outcomes. 2016 Jan 20;2(2):125-140. doi: 10.1093/ehjqcco/qcw003. PMID: 27042338


George J et al. How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1. PMID: 26330414


Morley KI et al. Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation. PLoS One. 2014 Nov 4;9(11):e110900. doi: 10.1371/journal.pone.0110900. eCollection 2014. PMID: 25369203


Pujades-Rodriguez M et al. Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20. PMID: 25416721


Pujades-Rodriguez M et al. Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014. PMID: 25144739


Rapsomaniki E et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1. PMID: 24881994


Shah AD et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1.9 million people. Lancet Diabetes Endocrinol. 2015 Feb;3(2):105-13. doi: 10.1016/S2213-8587(14)70219-0. Epub 2014 Nov 11. PMID: 25466521


Rapsomaniki E et al. Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients. Eur Heart J. 2014 Apr;35(13):844-52. doi: 10.1093/eurheartj/eht533. Epub 2013 Dec 17. PMID: 24353280