The American Heart Association (AHA) and the American College of Cardiology (ACC) have published the 2019 AHA/ACC Clinical Performance and Quality Measures for Adults with High Blood Pressure, in Circulation: Cardiovascular Quality and Outcomes.1

According to a recent analysis of the 2011-2014 United States National Health and Nutrition Examination Survey, 46% of US adults have high blood pressure (HBP). An additional 12% of United States have elevated blood pressure and are at high risk of HBP as well. Early diagnosis and effective treatment of HBP is critical to reducing the risks of cardiovascular disease, stroke, and kidney failure and increasing mortality, according to AHA.2

Twenty-two measures for the diagnosis and treatment of HBP were developed through the writing process of the Clinical Performance and Quality (CPQ) Measures: 6 performance measures, 6 process quality measures and a new category of 10 structural quality measures. These new structural quality measures are designed to evaluate the capability and capacity of various levels of the US health care system to implement the recommendations of the 2017 Hypertension Clinical Practice Guidelines.2

The writing committee unanimously decided to include new harmonizing measures and a composite measure indicating the importance of controlling HBP below the new ACC/AHA target of 130/80 mm Hg, as recommended by the 2017 Hypertension Clinical Practice Guidelines, according to the report.1

The new measures also include additional emphasis on nonpharmacological interventions across all stages of HBP, with high-quality evidence and strong recommendation for promoting lifestyle modification as an important strategy for controlling HBP. Medication adherence to drug therapy for ACC/AHA stage 1 with atherosclerotic cardiovascular disease risk  ≥10% or ACC/AHA stage 2 HBP was also highlighted.1

The new AHA/ACC performance measurement sets with the CPQ Measures serve as vehicles to accelerate translation of scientific evidence into clinical practice. Measure sets are intended to provide practitioners and institutions that deliver cardiovascular care with tools to measure the quality of care provided and identify opportunities for improvement, and to provide guidance on further research to achieve optimal patient care and outcomes.2

The measures were constructed to maximally capture important aspects of quality of care: timeliness, safety, effectiveness, efficiency, equity, and patient-centeredness while minimizing the reporting burden on hospitals, practices, and practitioners.1

The writing committee of the new CPQ Measures included 12 experts convened by the ACC and the AHA, assembled in 2018 by the ACC/AHA Task Force on Performance Measures.1

  1. Casey DR, Thomas RJ, Bhalla V, et al. 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure: A report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circulation: Cardiovascular Quality and Outcomes. 2019.
  2. The American Heart Association and the American College of Cardiology publish new, joint 2019 Clinical Performance and Quality Measures for Adults with High Blood Pressure [press release]. Published November 12, 2019. Accessed November 15, 2019.