Eligibility
stroke, chronic kidney disease, organ damage, peripheral artery disease
MYOCARDIAL INFARCTION, PERIPHERAL ARTERY DISEASE, TRANSIENT ISCHEMIC ATTACK, STROKE, CONGESTIVE HEART FAILURE, HYPERTENSION, CORONARY ARTERY DISEASE
Primary care practices that served adult patients, were part of the ACN, and whose medical directors agreed to participate were included. Of 10 such practices, the 2 used for pilot testing the implementation strategy were excluded. Patients were identified through the EHR and were included if they were 18 years old or older, had not previously been diagnosed with hypertension, and had high office BP (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) during at least 1 scheduled visit with a primary care clinician at an eligible practice during the relevant time period, hereafter referred to as eligible visits. If multiple BP readings were documented in the flowsheet, the mean was used to determine eligibility. Patients were excluded if they had a prior diagnosis of hypertension; a prior evaluation for white-coat hypertension; prior prescribed antihypertensive medication; office BP less than 140/90 mm Hg; severely elevated office BP (systolic BP ≥180 mm Hg or diastolic BP ≥110 mm Hg); or evidence of target organ damage (chronic kidney disease with creatinine levels >1.5 mg/dL [to convert to millimoles per liter, multiply by 88.4], prior history of stroke, transient ischemic attack, coronary artery disease, myocardial infarction, congestive heart failure, or peripheral artery disease). As each visit at which patients had elevated office BP represented an opportunity to order out-of-office BP monitoring, patients could be eligible at more than 1 visit.