title: Implementing standardized performance indicators to improve hypertension control at both the population and healthcare organization levels.
abstract: The ability to reliably evaluate the impact of interventions and changes in hypertension prevalence and control is critical if the burden of hypertension-related disease is to be reduced. Previously, a World Hypertension League Expert Committee made recommendations to standardize the reporting of population blood pressure surveys. We have added to those recommendations and also provide modified recommendations from a Pan American Health Organization expert meeting for "performance indicators" to be used to evaluate clinical practices. Core indicators for population surveys are recommended to include: (1) mean systolic blood pressure and (2) mean diastolic blood pressure, and the prevalences of: (3) hypertension, (4) awareness of hypertension, (5) drug-treated hypertension, and (6) drug-treated and controlled hypertension. Core indicators for clinical registries are recommended to include: (1) the prevalence of diagnosed hypertension and (2) the ratio of diagnosed hypertension to that expected by population surveys, and the prevalences of: (3) controlled hypertension, (4) lack of blood pressure measurement within a year in people diagnosed with hypertension, and (5) missed visits by people with hypertension. Definitions and additional indicators are provided. Widespread adoption of standardized population and clinical hypertension performance indicators could represent a major step forward in the effort to control hypertension.
authors.affiliation: Departments of Medicine, Physiology and Pharmacology and Community Health Sciences, Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Norm
authors.identifier: http://orcid.org/0000-0002-1093-4742
authors.initials: N
authors.lastname: Campbell
authors.affiliation: Department of Non Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ordunez
authors.affiliation: Department of Endocrinology, Kaiser Permanente, South San Francisco, CA, USA.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jaffe
authors.affiliation: The National University of Cordoba and Sanatorio Allende, Cordoba, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Orias
authors.affiliation: University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: DiPette
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Pragna
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Medicine, Center for Health Evaluation and Outcomes Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Khan
authors.affiliation: Management of Noncommunicable Diseases Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Oyere
authors.initials: O
authors.lastname: Onuma
authors.affiliation: Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods / Q000592:standards*; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents