In for- mulating these new performance measures, the writing committee was sensitive to the fact that there is cur- rently not complete consensus among other guidelines from the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP)8 and also the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH).9 Nonetheless, despite this ongoing debate, the writing committee felt strongly that it is now time to move the US healthcare system ahead to reflect these differing points of view and expects that widespread use of this new measure set will help to achieve this goal. In addition, the writing committee was concerned that NCQA and CMS would be less likely to consider testing and adopting performance measures with denominator specifications different from those of the Controlling High Blood Pressure measure currently in widespread use (and recently revised in 2019).10 Therefore, the writ- ing committee chose to promote flexible denominator congruity and harmonization (as defined by the National Quality Forum [NQF]) with both NCQA and CMS mea- sure specifications in the new ACC/AHA performance measure set to promote its initial widespread use by cli- nicians and entities who support the treatment recom- mendations for ACC/AHA stage 1 HBP as emphasized in the 2017 Hypertension Clinical Practice Guidelines.4 This new performance measure set also includes a new com- posite measure for control of HBP for both ACC/AHA Table 1. Applying Class of Recommendation and Level of Evidence to Clinical Strategies, Interventions, Treatments, or Diagnostic Testing in Patient Care (Updated August 2015)* 5 stage 2 and ACC/AHA stage 1 to a systolic goal of <130 mmHg. 