Percentage of patients aged 18-85 years of age with a diagnosis of hypertension whose blood pressure improved during the measurement period.

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CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.

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High blood pressure is one of the most common risk factors for cardiovascular disease and stroke. Less than half of those with hypertension have their condition controlled. Uncontrolled and untreated hypertension was associated with increased risk of total and cardiovascular mortality among the general hypertensive population. Health-care system improvements, including use of electronic health records with registry and clinical decision support functions, could facilitate better treatment and follow-up management, and improve patient-physician interaction.

Epidemiological studies and randomized trials have repeatedly demonstrated that the relative risk of cardiovascular disease increases continuously with increasing levels of BP. The benefit of lowering a high blood pressure is to reduce the risk of developing a cardiovascular disease in the future. For example, it is estimated that reducing a high diastolic blood pressure by 6 mm Hg reduces your relative risk of having a stroke in the future by about 35-40%, and reduces your relative risk of developing heart disease by about 20-25%. Larger reductions in blood pressure provide greater benefits.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): Treating systolic blood pressure and diastolic blood pressure to targets that are <140/90 mmHg is associated with a decrease in cardiovascular disease complications

A higher score indicates better quality

Prevention, Detection, Evaluation, and Treatment of High Blood Pressure - The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No.03 - 5233 December 2003

MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J. Blood pressure, stroke, and coronary heart disease, part 1: prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990;335:765–774.[Medline] [Order article via Infotrieve]

Kannel WB, Belanger AJ. Epidemiology of heart failure. Am Heart J. 1991;121:951–957.[Medline] [Order article via Infotrieve]

Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J. Blood pressure and end-stage renal disease in men. N Engl J Med. 1996;334:13–18.[Medline] [Order article via Infotrieve]

He J, Whelton PK. Elevated systolic blood pressure and risk of cardiovascular and renal disease: an overview of evidence from observational epidemiologic studies and randomized controlled trials. Am Heart J.. 1999;138:S211–S219.

Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke, and coronary heart disease, part 2: short-term reductions in blood pressure: overview of randomized drug trials in their epidemiological context. Lancet. 1990;335:827–838.

http://www.patient.co.uk/health/High-Blood-Pressure-(Hypertension).htm

Adequate control: a systolic blood pressure < 140 mmHg. 

Uncontrolled blood pressure: a systolic blood pressure >= 140 mmHg.

Uncontrolled baseline blood pressure: systolic blood pressure >= 140 mmHg that is taken during the first outpatient encounter of the measurement year in which the patient has an active diagnosis of hypertension. This must occur during the first six months of the year. If the patient with hypertension has uncontrolled blood pressure during the first outpatient encounter of the measurement year, then include the patient in the initial patient population of the measure.

Follow-up blood pressure: systolic blood pressure taken during the first outpatient encounter during the measurement year that occurs at least six months after the baseline blood pressure.

Improvement in blood pressure: the follow-up blood pressure is at least 10 mmHg less than the baseline systolic blood pressure.

Blood pressure readings must be taken while the patient is sitting. If multiple measurements occur on the same date, the last systolic and diastolic readings should be used.

"Occurrence A of Physical Exam, Finding: Systolic Blood Pressure (result)" represents the baseline blood pressure, which must occur prior to "Occurrence B of Physical Exam, Finding: Systolic Blood Pressure (result)", which represents the follow-up blood pressure.

To calculate the “Physical Exam, Finding: Delta systolic blood pressure (result)” data element, subtract the value of "Occurrence B of Physical Exam, Finding: Systolic Blood Pressure (result)" from the value of "Occurrence A of Physical Exam, Finding: Systolic Blood Pressure (result)". 

The data element “Physical Exam, Finding: Delta systolic blood pressure (result)” is intended to represent the result of the mathematic comparison between systolic blood pressures taken during two separate visits. This is a calculation artifact, and there’s no requirement to document the delta data element in the medical record.

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All patients aged 18-85 years of age, who had at least one outpatient visit in the first six months of the measurement year, who have a diagnosis of essential hypertension documented during that outpatient visit, and who have uncontrolled baseline blood pressure at the time of that visit

Equals Initial Patient Population

Exclude from the denominator all patients with evidence of end-stage renal disease (ESRD) on or prior to December 31 of the measurement year. Documentation of dialysis or kidney transplant also meets the criteria for evidence of ESRD.

Exclude from the denominator all patients with a diagnosis of pregnancy during the measurement year.

Patients whose follow-up blood pressure is at least 10 mmHg less than their baseline blood pressure or is adequately controlled.

If a follow-up blood pressure reading is not recorded during the measurement year, the patient’s blood pressure is assumed “not improved.”

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Not Applicable

For every patient evaluated by this measure also identify payer, race, ethnicity and sex.