Cardiovascular Health Indicator
Measure: Controlling High Blood Pressure

Analysis

As shown in Table 1, more than three out of four Minnesotans aged 18-85 with diagnosed high blood pressure had their blood pressure under control. The measure definition changed slightly beginning in 2014, making it difficult to compare results prior to that date. Blood pressure control rates were at their highest in 2016-2017 but have declined in recent years. Blood pressure control declined sharply in 2020 due in large part to the COVID-19 pandemic impacting the ability of many patients to access primary care, their providers, and sometimes their medications.

Table 1: Controlling High Blood Pressure by Year, 2011-2020

*Measure definition changed in 2014, requiring adults aged 60-85 without diabetes to only meet a 150/90 mm Hg threshold

Table 2 and Chart 1 show that hypertensive Minnesotans with insurance coverage through Minnesota Health Care Programs (MHCP) have lower rates of blood pressure control than those with other types of insurance, including commercial insurance and Medicare. These blood pressure control improvements have narrowed the gap between MHCP patients and patients on other types of insurance from more than 8 percentage points in 2014 to less than 2 percentage points in 2020.

Table 2: Controlling High Blood Pressure by Minnesota Health Care Program Insurance Status, 2014-2020

Chart 1: Controlling High Blood Pressure by Minnesota Health Care Program Insurance Status, 2014-2020

Table 3 shows that White adults with MHCP insurance have a rate of blood pressure control that is significantly higher than the MHCP statewide rate (66.6% vs 62.3%). The rates for Asian and Black or African American people are significantly lower than the MHCP statewide rate (54.8% and 53.7% vs 62.3%). Other race and ethnic groups with MHCP insurance do not have a significantly different rate of blood pressure control than the state.

Table 3: Controlling High Blood Pressure by Race and Ethnicity, Minnesota Health Care Program Members, 2020

*Difference from state is not statistically significant.

Other Resources

• Minnesota Community Measurement: Health Care Quality Report
  The Health Care Quality Report has been produced since 2004 and features statewide and medical group performance on a number of clinical quality measures, including Controlling High Blood Pressure.
  Scroll to "Health Care Quality" under "Community Reports" to access these reports.


• Minnesota Community Measurement: Disparities by Insurance Type Report
  The Disparities by Insurance Type Report (previously named the Health Care Disparities Report) has been produced since 2007 and highlights differences by insurance type (Minnesota Health Care Programs vs. other types of insurance) for a number of clinical quality measures, including Controlling High Blood Pressure.
  Scroll to "Disparities by Insurance Type" under "Community Reports" to access these reports.


• Minnesota Department of Health Managed Care Section HEDIS Reports
  The Minnesota Department of Health Managed Care Section provides links to downloadable annual reports including dozens of quality measures for Health Plans operating in Minnesota, including Controlling High Blood Pressure.

Data Source

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool created by the National Committee for Quality Assurance (NCQA) to collect data about the quality of care and services provided by managed care health plans (including Commercial, Minnesota Health Care Programs and Medicare). NCQA requires health plans to collect this information in the same manner so that results can be fairly compared to one another.

Data collected for this measure are from health plan claims and medical record review. Measure results are calculated from a sample of less than 10% of the total eligible managed care population.

Measure Definition

This measures the percentage of patients ages 18-85 with a diagnosis of hypertension, or high blood pressure, whose blood pressure was adequately controlled based on the following criteria:

• Patients ages 18-59 whose blood pressure was less than 140/90 mmHg
• Patients ages 60-85 with a diagnosis of diabetes whose blood pressure was less than 140/90 mmHg
• Patients ages 60-85 without a diagnosis of diabetes whose blood pressure was less than 150/90 mmHg

The representative blood pressure is the most recent blood pressure reading during the measurement year (as long as the blood pressure reading occurred following the hypertension diagnosis).