U.S. flag

An official website of the United States government

Controlling High Blood Pressure: Ages 18 to 85

DOMAIN: Chronic Conditions

High blood pressure, or hypertension, increases the risk of heart disease and stroke—the leading causes of death in the United States. Controlling high blood pressure is an important step in preventing heart attacks, strokes, and kidney disease. It also reduces the risk of developing other serious conditions.

Explore the percentage of adults with a diagnosis of hypertension whose blood pressure was adequately controlled in each state. Higher rates are better on this measure.

The purple dashed line represents the median, or middle, of all values reported.

This measure reports state performance on the percentage of adults ages 18 to 85 diagnosed with hypertension with adequately controlled blood pressure, defined as less than 140/90 mm Hg, during the measurement year.

This measure aligns with the Centers for Disease Control and Prevention’s 6|18 Initiative focus on blood pressure control. The 6|18 Initiative focuses on six common and costly health conditions or health behaviors, including high blood pressure, and highlights evidence-based interventions that can prevent or control those conditions. For information on how to drive improvement on this measure, visit: www.cdc.gov/sixeighteen.  

States voluntarily report on Controlling High Blood Pressure (CBP-AD) as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.

The included populations and calculation methods for Adult Core Set measures can vary by state. For example, some states include populations in certain programs, such as beneficiaries covered by Medicaid, but exclude beneficiaries in other programs, such as those dually eligible for Medicare and Medicaid. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. States can also choose to calculate this measure using the administrative or hybrid method. This variation in populations and calculation methods can affect measure performance and comparisons between states.

Specifications for this measure changed substantially for Federal Fiscal Year (FFY) 2019. Rates are not comparable with rates reported for previous years.

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Adult Core Set Federal Fiscal Year (FFY) 2020 reporting cycle as of June 18, 2021; see 2020 Child and Adult Health Care Quality Measures. For more information on the Controlling High Blood Pressure (CBP-AD) measure, visit Adult Health Care Quality Measures.


The term “states” includes the 50 states, the District of Columbia, and Puerto Rico. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, AZ, CA, IA, ID, IL, ME, MI, MN, MO, MT, NC, NE, NY, OK, PR, SD, and WY.

The following state reported the measure to CMS, but did not use Adult Core Set specifications to calculate the measure: AR. CMS did not include the rate for this state.  

The Adult Core Set specifications include guidance for calculating this measure using the administrative method or the hybrid method. The hybrid method uses a combination of administrative and medical records data to identify services included in the numerator or to determine exclusions from the denominator based on diagnoses or other criteria. Unless otherwise specified, administrative data sources are the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans; medical record data sources are paper and/or electronic health records. This measure is also specified for calculation using electronic health records.

Unless otherwise specified:

  • States used Adult Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2020 specifications. The following state used National Committee for Quality Assurance 2019 specifications: OR.
  • Denominators are assumed to be the measure-eligible population for states using the administrative method; states using the hybrid method often reported the sample size for the medical chart review rather than the measure-eligible population. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was January 2018 to December 2019. TN reported data for January 2017 to December 2018 and KY reported data for FFY 2019.
  • Rates displayed reflect state reporting for Medicaid enrollees ages 18 to 64 (16 states) or ages 18 to 85 (17 states).

ACO = Accountable Care Organization; AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.