New 2019 clinical performance and quality measures for adults with high blood pressure

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

A recent analysis of the 2011-2014 U.S. National Health and Nutrition Examination Survey estimates that 46 percent of U.S. adults have high blood pressure (HBP), which equals >100 million Americans. It is also estimated that an additional 12 percent of U.S. adults have elevated blood pressure and are at high risk of HBP. In addition, 53 percent of adults taking antihypertensive medication have uncontrolled BP. Early diagnosis and effective treatment of HBP is critical to reducing the risks of cardiovascular disease, stroke and kidney failure and increasing mortality.

Through the writing process of the new Clinical Performance and Quality (CPQ) Measures, 22 new measures for the diagnosis and treatment of HBP were developed: six performance measures, six process quality measures and a new category of 10 structural quality measures. The new structural quality measures are designed to evaluate the capability and capacity of various levels of the U.S. health care system to implement the recommendations of the 2017 Hypertension Clinical Practice Guidelines. All 22 new measures are detailed in several tables in the CPQ Measures document. Descriptive and technical specifications for each measure are listed in Appendix A.

The new AHA/ACC performance measurement sets detailed in the CPQ Measures serve as vehicles to accelerate translation of scientific evidence into clinical practice. Measure sets developed by the ACC and AHA 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 needed to achieve optimal patient care and outcomes.

The new CPQ Measures are aligned with the ACC/AHA clinical care guidelines and the measures were constructed to maximally capture important aspects of quality of care, including timeliness, safety, effectiveness, efficiency, equity and patient-centeredness, while minimizing, when possible, the reporting burden imposed on hospitals, practices and practitioners. The Writing Committee developed new measures to evaluate patient care in accordance with the 2017 Hypertension Clinical Practice Guidelines, with close attention to the importance of measuring for atherosclerotic cardiovascular disease (ASCVD) risk for all patients with HBP regardless of stage.