{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:17:26Z","timestamp":1787804246641,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Health care systems have a key role in improving hypertension control in large populations, a global challenge, through the implementation of modern multicomponent programs. The impact of such programs in at\u2010risk minority populations, nonetheless, remains to be better characterized. Additionally, the extent to which hypertension control based on a single time\u2010point blood pressure (BP) measurement (LAST\u2010BP), the approach typically used in health system performance assessment, agrees with time\u2010averaged BP (AVG\u2010BP) has not been well studied. Leon Medical Centers (LMC), a major integrated health care system serving Medicare beneficiaries predominantly of Hispanic origin in Miami\u2010Dade County, Florida, implemented a hypertension control program in 2011. We conducted longitudinal data analysis evaluating hypertension control before and after program implementation, and compared annual rates derived from AVG\u2010BP versus LAST\u2010BP. During 2008\u20132018, the analytic sample increased from 4,710 to 21,540, mean age rose from 73.4 to 77.1 years, and the proportion of Hispanics remained stable (&gt;98%). Adjusted odds of hypertension control were 5.7 (95% CI: 5.4\u20136.0) times higher after full program implementation. Improvements were comparable in women and men. Trends based on LAST\u2010BP paralleled those of AVG\u2010BP, although rates were consistently lower. Kappa agreement between AVG\u2010BP and LAST\u2010BP metrics was only fair. The LMC program was associated with a meaningful, sustained increase in hypertension control to high levels (crude rates based on AVG\u2010BP \u223c 90%). LAST\u2010BP\u2010based control rates underestimated those derived from AVG\u2010BP. Research is warranted to determine how longitudinal BP metrics can be optimally incorporated into patient care and health system performance assessment.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Practical Applications<\/jats:bold>\n                    : This study has two practical implications. First, it shows that a coordinated, multicomponent hypertension control program with modern core elements, including team\u2010based care, standardized blood pressure measurement, and promotion of guideline\u2010based management supported by a robust EHR system and enhanced pharmacy and transportation services, and culturally tailored patient engagement, can achieve and sustain high levels of hypertension control in the understudied population of Hispanic Medicare beneficiaries in South Florida. These findings provide a strong foundation for real\u2010world primary care settings, while highlighting the need for continued program refinement as the science of blood pressure (BP) control in large populations evolves.\n                  <\/jats:p>\n                  <jats:p>Second, the study shows that a single annual \u201csnapshot\u201d BP value underestimates true hypertension control compared with the average of readings obtained throughout the year. This finding supports the value of longitudinal BP metrics and highlights the need for research to determine how best to incorporate them into performance assessment.<\/jats:p>","DOI":"10.1111\/jch.70297","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T06:46:46Z","timestamp":1785912406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertension Control Rates Before and After Implementation of a Multicomponent Quality Improvement Program in Medicare Beneficiaries Primarily of Hispanic Origin in a Large Health System in South Florida, 2011\u20132018"],"prefix":"10.1111","volume":"28","author":[{"given":"Paulo H. 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