SELECT  count(*) as criticalCases
  FROM patient_vitals_state pvs
  INNER JOIN user u on u.uuid = pvs.patient_uuid
  WHERE EXISTS (
    SELECT pc.clinic_uuid FROM patient_clinics pc
      WHERE pc.clinic_uuid IN (?) AND pc.patient_uuid = u.uuid
    )
  AND pvs.avg_sbp >= 181
  AND pvs.last_reading BETWEEN NOW() - INTERVAL 7 DAY AND NOW()