The American Heart Association (AHA) and the American College of Cardiology (ACC) jointly published new, 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% of U.S. adults have high blood pressure (HBP), which equals >100 million Americans. It is also estimated that an additional 12% of U.S. adults have elevated blood pressure and are at high risk of HBP. In addition, 53% 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: 6 performance measures, 6 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.
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. This Physician Performance Measurement Set (PPMS) and related data specifications were developed by the Physician Consortium for Performance Improvement (the Consortium), including the American College of Cardiology (ACC), the American Heart Association (AHA), and the American Medical Association (AMA), to facilitate quality-improvement activities by physicians. Additional collaborators included the Preventive Cardiovascular Nurses Association, and the measures have been endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Association of Clinical Endocrinologists, the American Nurses Association, the American Society for Preventive Cardiology, the American Society of Health-System Pharmacists and the Association of Black Cardiologists.
ACC/AHA Task Force Members are Gregg C. Fonarow, M.D., FACC, FAHA, Chair; Biykem Bozkurt, M.D., Ph.D., FACC; Sandeep Das, M.D., M.P.H.; Michael E. Hall, M.D., M.S., FAHA, FACC; Hani Jneid, M.D., FACC, FAHA; Corrine Y. Jurgens, Ph.D., R.N., A.N.P.-B.C., FAHA; Patricia Keegan, N.P., A.P.R.N., N.P.-C.; Rohan Khera, M.D.; Leo Lopez, M.D., FACC; Jeffrey W. Olin, D.O., FACC, FAHA; Manesh Patel, M.D., FACC; Faisal Rahman, B.M.B.Ch.; Matthew Roe, M.D., FACC; Alex Sandhu, M.D., M.S.; Randal J. Thomas, M.D., M.S., FACC, FAHA; Muthiah Vaduganathan, M.D., M.P.H.; Paul D. Varosy, M.D., FACC; Siqin Ye, M.D., M.S.; and Boback Ziaeian, M.D., Ph.D., FACC.
Writing committee members are Donald E. Casey, Jr., M.D., M.P.H., M.B.A., FAHA, Chair; Randal J. Thomas, M.D., M.S., FACC, FAHA, Vice Chair; Vivek Bhalla, M.D., FAHA; Yvonne Commodore-Mensah, Ph.D., R.N., FAHA, FPCNA; Paul A. Heidenreich, M.D., M.S., FACC, FAHA; Dhaval Kolte, M.D., Ph.D.; Paul Muntner, Ph.D., FAHA; Sidney C. Smith, Jr., M.D., MACC, FAHA; John A. Spertus, M.D., M.P.H., FACC, FAHA; John R. Windle, M.D., FACC; Gregory D. Wozniak, Ph.D.; Boback Ziaeian, M.D., Ph.D., FACC. Author disclosures are available on the manuscript.
The work of the Writing Committee was supported exclusively by the ACC and the AHA without commercial support, and members of the Writing Committee volunteered their time.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.
About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.