Million Hearts Hypertension Control Champions, 2012–2019

Million Hearts, a national initiative co-led by CDC and the Centers for Medicare & Medicaid Services, set out to prevent 1 million heart attacks, strokes and other acute cardiovascular events by 2022. Because high blood pressure is a leading modifiable risk factor for heart disease and stroke, the initiative focuses on getting it under control. Its annual Hypertension Control Challenge recognizes clinicians and health systems that do this exceptionally well, to draw attention to blood pressure control, create urgency around it and spread strategies that work.

The 2019 Champions

On November 19, 2019, Million Hearts named 17 Hypertension Control Champions for achieving blood pressure control in at least 80% of their patients with hypertension. They included clinicians, practices, health centers and health systems in 15 states caring for 201,045 adult patients, about a third of whom (68,019) had hypertension.

Since 2012, the challenge has recognized 118 Champions from 36 states and the District of Columbia, together caring for more than 15 million adults, including 5 million with hypertension. The challenge runs every year: applications open in spring, are reviewed and vetted over the summer, and Champions are announced in late fall.

The bar to clear

To qualify in 2019, applicants needed at least 500 adult patients and a control rate of 80% or higher among patients aged 18–85 with diagnosed hypertension over a 12-month period starting on or after January 1, 2018. Control meant a last blood pressure reading below 140/90 mm Hg, matching the performance measures the health care sector uses. By those measures, about 75 million U.S. adults have hypertension, and only half have it under control. Eligibility was checked, and part of each applicant's data was validated by external review.

Who won

All 17 Champions were in the private sector. Nine served only rural areas, and five were health centers funded by the Health Resources and Services Administration.

How they did it

The results show that high control rates are achievable in many kinds of settings, including among patients at high risk of uncontrolled hypertension. This year's Champions pointed to:

• a clinician dedicated to leading hypertension quality improvement;
• frequent office visits until a patient's blood pressure was controlled;
• treatment protocols and patient registries supported by electronic health records to guide treatment and follow-up;
• performance reports giving clinicians feedback; and
• engaging patients in measuring their own blood pressure, to track progress, inform decisions and encourage them to stick with treatment.

Applying these strategies more widely could raise hypertension control rates nationally and reduce heart disease and stroke.

Sources

• Matthew D. Ritchey, Judy Hannan, Hilary K. Wall, Mary G. George and Laurence S. Sperling, "Notes from the Field: Characteristics of Million Hearts Hypertension Control Champions, 2012–2019," Morbidity and Mortality Weekly Report, CDC: https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a5.htm