Table 3.

Percentage of Clinics Adherent to US Preventive Services Task Force Recommendations

USPSTF Recommendation6Utah Million Hearts Assessment QuestionClinics Adherent to Recommendation, % (95% CI)
In-office blood pressure measurement
    Use the mean of 2 measurementsQ11: Repeat the measurement within 1 to 2 minutes and use the mean of 2 measures58.5 (49.7–67.4)
    Measure while the patient is seatedQ5: Patient seated in a chair with back support87.0 (81.0–93.0)
    Allow for ≥5 minutes between entry into office and BP measurementQ8: Measure BP after the patient has rested quietly for 5 minutes before measurement57.7 (48.9–66.6)
    Use an appropriately sized arm cuffQ10: Use a cuff size appropriate to the patient's midarm circumference93.5 (89.1–97.9)
    Place the patient's arm at the level of the right atriumQ7: Measure BP with the patient arm and cuff at midsternal level84.6 (78.1–91.0)
Out-of-office hypertension diagnosis confirmation
    ABPM may be used to confirm a diagnosis after initial screeningQ18: Practice has access to 24-hour ABPM studies25.2 (17.4–33.0)
    HBPM may be used to confirm a diagnosis after initial screeningQ15: Practice has a written policy for training patients on accurate HBPM27.6 (19.6–35.7)
Q16: Staff distribute materials for HBPM for newly diagnosed patients or those with uncontrolled hypertension36.6 (28.0–45.2)
Q17: Practice designates at least 1 member of the care team to provide individualized training in accurate HBPM48.8 (39.8–57.7)
    Recommends use of a regular screening intervalQ23: Practice has a system to alert patients with uncontrolled hypertension of a missed appointment or overdue BP check55.3 (46.4–64.2)
  • ABPM, 24-hour ambulatory blood pressure monitoring; CI, confidence interval; BP, blood pressure; HBPM, home blood pressure monitoring; USPSTF, US Preventive Services Task Force.