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## Complete Summary

#### TITLE

Hypertension diagnosis and treatment: percentage of patients who have
blood pressure less than 140/90 mmHg at the clinic visit.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Hypertension
diagnosis and treatment. Bloomington (MN): Institute for Clinical
Systems Improvement (ICSI); 2006 Oct. 53 p. \[99 references\]

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Outcome

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of patients with
hypertension who had a blood pressure reading less than 140/90 mmHg at
their last clinic visit.

#### RATIONALE

The priority aim addressed by this measure is to increase the percentage
of patients in blood pressure control.

#### PRIMARY CLINICAL COMPONENT

Hypertension; blood pressure control (less than 140 mmHg systolic and
less than 90 mmHg diastolic)

#### DENOMINATOR DESCRIPTION

Number of patients age 18 to 60 years that have a diagnosis of
hypertension (see the related \"Denominator Inclusions/Exclusions\"
field in the Complete Summary)

#### NUMERATOR DESCRIPTION

Number of patients with a diagnosis of hypertension who had a blood
pressure reading at their last visit less than 140 mmHg systolic and
less than 90 mmHg diastolic (see the related \"Numerator
Inclusions/Exclusions\" field in the Complete Summary)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A clinical practice guideline or other peer-reviewed synthesis of
    the clinical evidence

#### NATIONAL GUIDELINE CLEARINGHOUSE LINK

-   [Hypertension diagnosis and
    treatment.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10225)

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Unspecified

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Age 18 to 60 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Living with Illness

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Number of patients age 18 to 60 years that have a diagnosis of
hypertension

Medical groups may generate a list of patients meeting the inclusion
criteria. This list would be newly created not less than every 6 to 12
months to remain current. Data may be collected by medical record
review. Identify the blood pressure at the most recent office visit.

After review in one month, all eligible patients would return to the
pool of eligible patients from which the following month\'s sample of
charts would be randomly drawn.

Randomly selected cases may be reviewed monthly.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of patients age 18 to 60 years that have a diagnosis of
hypertension\*

\*Patients between the ages of 18 and 60 years who have had an office
visit within the previous 12 months having primary, secondary, or
tertiary International Classification of Diseases, Ninth Revision
(ICD-9) codes 401.0, 401.1, and/or 401.9.

**Exclusions**\
Unspecified

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Encounter

#### DENOMINATOR TIME WINDOW

Time window is a fixed period of time

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of patients with a diagnosis of hypertension who had a blood
pressure reading at their last visit less than 140 mmHg systolic and
less than 90 mmHg diastolic\*

\*Calculate the average of two or more systolic blood pressure (SBP) and
diastolic blood pressure (DBP) readings taken at the most recent office
visit to determine level of control. Go to the previous office visit if
the most recent office visit was for sigmoidoscopy, injuries, or a visit
at which local anesthesia such as lidocaine was given for a procedure.
The mean of two or more systolic and the mean of two or more diastolic
readings taken at the selected visit would be calculated. The mean SBP
and mean DBP may then be used to determine whether the patient has a
blood pressure less than 140/90 mmHg.

**Exclusions**\
Unspecified

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Encounter or point in time

#### DATA SOURCE

Administrative data\
Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Not Individual Case

#### OUTCOME TYPE

Clinical Outcome

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Percentage of patients who have blood pressure less than 140/90 mmHg at
the clinic visit.

#### MEASURE COLLECTION

[Hypertension Diagnosis and Treatment
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=4521)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2003 Apr

#### REVISION DATE

2006 Oct

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Hypertension diagnosis and treatment. Bloomington
(MN): Institute for Clinical Systems Improvement (ICSI); 2005 Oct. 53 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Hypertension
diagnosis and treatment. Bloomington (MN): Institute for Clinical
Systems Improvement (ICSI); 2006 Oct. 53 p. \[99 references\]

#### MEASURE AVAILABILITY

The individual measure, \"Percentage of patients who have blood pressure
less than 140/90 mmHg at the clinic visit,\" is published in \"Health
Care Guideline: Hypertension Diagnosis and Treatment.\" This document is
available from the [Institute for Clinical Systems Improvement (ICSI)
Web
site](http://www.icsi.org/guidelines_and_more/guidelines__order_sets___protocols/).

For more information, contact ICSI at, 8009 34th Avenue South, Suite
1200, Bloomington, MN 55425; phone: 952-814-7060; fax: 952-858-9675; Web
site: [www.icsi.org](http://www.icsi.org/); e-mail:
<icsi.info@icsi.org>.

#### NQMC STATUS

This NQMC summary was completed by ECRI on February 6, 2004. This
summary was updated by ECRI on July 27, 2004, on November 16, 2005 and
again on January 23, 2007.

#### COPYRIGHT STATEMENT

This NQMC summary (abstracted Institute for Clinical Systems Improvement
\[ICSI\] Measure) is based on the original measure, which is subject to
the measure developer\'s copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be
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If the abstracted ICSI Measures are downloaded by an organization,
copies may be distributed to the organization\'s employees but may not
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consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved
by the Institute for Clinical Systems Improvement, Inc. The Institute
for Clinical Systems Improvement, Inc. assumes no liability for any
adaptations or revisions or modifications made to the abstracts of the
ICSI Measures.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008