ASH COMPREHENSIVE HYPERTENSION CENTER APPLICATION FORM
*ASH Comprehensive Hypertension Centers are located in either academic medical centers or in large multi-specialty
clinics. These centers may exist independently or as part of larger divisions or departments.
INSTITUTIONS APPLYING FOR DESIGNATION AS AN ASH DESIGNATED COMPREHENSIVE HYPERTENSION CENTER
MUST (1) DOWNLOAD THE APPLICATION FORM* AT www.ash-us.org; (2) type in and complete the information on the form;
(3) submit as a hardcopy file with any supporting documentation (CVs, certificates, procedure and protocol documents) (5) pay
the non-refundable application fee of $4,500. Centers will be invoiced for travel expenses for an on-site review if applicable.
PART I
HYPERTENSION CENTER INFORMATION
Institution/Organization
Division/Department
Mailing Address: Number and Street
City
Website
Title
Apt./Mail Stop/Room/Box Number
State
Postal Code
Phone
Country
Fax
Email
MEDICAL DIRECTOR (Please provide CV)
Name
Title
Phone
Email
Designated Hypertension Specialist: Yes No
Year in which last designated or re-designated _____
Academic Appointment: Yes No
Current member of the American Society of Hypertension, Inc. (ASH): Yes
Fellow of the American Society of Hypertension (FASH): Yes
No
Attended most recent ASH Annual Scientific Meeting: Yes No
No
Support Staff with direct treatment roles (MDs, DOs, APRNs, PAs,PharmDs).(Please list and provide CV’s for each)
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PART II
Please answer the following questions and submit supporting document(s):
1. Describe the goals of why your Center wishes to be designated as an ASH Comprehensive Hypertension Center?
2. Describe how the Center is organized as a hypertension center by the parent organization, encouraging collaboration with
other disciplines, e.g., nephrology, cardiology, etc.
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Does the Center exist as a stand-alone entity or is it part of a larger division or department?
To whom does the Center Medical Director report, e.g. Department Head, Division Head, Dean?
Are personnel assigned to the Center on a full- or part-time basis? (i.e, physicians, medical support staff, management
personnel)
Does the Center have its own budget?
Does the Center have the capacity to submit proposals for research funding?
What percentage of the Center is devoted to the management of patients referred for or primarily coded for
Hypertension?
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What is the annual volume of patients referred for or who are primarily coded for Hypertension?
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Describe how the Center is recognized, locally or regionally, as a referral and treatment resource for resistant and
secondary hypertension, and alternative therapies.
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Is the Center able to manage hypertension without referring patients further? What is your mechanism for cross-referrals?
3. Indicate which of the following the Center performs in order to perform extensive multi-specialty examination and treatment to
assess complicated hypertension problems. If a specific risk assessment, diagnostic tool or intervention is not performed at your
Center, please indicate your reasons why.
 Cardiovascular risk assessment:
o quantitative echocardiography
o exercise testing
o ankle-brachial index
o carotid doppler
o evaluation of autonomic function
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Diagnostic Evaluation:
o Renal angiography
o Renal vein renin sampling
o Doppler renal ultrasound
o CT Angiography
o MR Angiography
o Adrenal vein sampling for Aldosterone
Interventions:
o Renal angioplasty with/without stenting
o Laparoscopic adrenalectomy
o Sleep Lab
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4. Describe practice protocol for certifying Center personnel in recording blood pressure. Does the Center have dedicated
personnel to measure blood pressure, using the same methods every time? What is your training protocol? Are you aware of the
guidelines by several national and international societies and organizations in this regard? Which ones do you use?
Note: Guidelines can be found on the ASH website, www.ash-us.org. ASH recommends using The Seventh Report of the
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) Complete
Report: "Accurate Blood Pressure Measurement in the Office" (page 18, table 4)
5. How does the Center select its stationary equipment? (cf.: www.dableducational.org provides information which equipment is
independently validated) How does the Center maintain its equipment? How does the Center educate patients about home selfmonitoring? Does the Center provide exercise tests for hypertensive patients?
Please provide written procedures/guidelines for all of the above.
6. Provide copies of any educational materials given to patients. Provide any formal links you provide to your hypertensive
patients for reference.
7. Provide written Center protocol for:
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Performing 24-hour ambulatory blood pressure recording
o
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Which APBM machine do you use? Why did you choose this specific machine?
Interpreting 24-hour ambulatory blood pressure recording (please provide a sample report)
8. Describe how the Center performs ongoing quality improvement in accord with standardized quality performance guidelines,
reporting of NCQA indicators, patient outcomes, criteria. Please provide procedural documents for training of new and ongoing
personnel.
 Do you have an EMR? What kind of EMR system do you use?
 Do you use your EMR system to improve your delivery of care? Describe how you use it.
 Do you have a formal process of assessment of quality metrics related to hypertension and blood pressure
control? Describe this process.
 What percentage of patients in your Center achieve blood pressure control (treated to goal)?
 Does the Center participate in a Hypertension Patient Registry? If so, what registry?
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9. List the hypertension educational activities in which Center personnel participate on a regular annual basis and who attended.
10. List Center participation in research activities:
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Investigator-initiated research
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Multi-center trials and observational studies. If not, are you interested in participating in a multi-center trial or
observational study?
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Basic Science
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Studies
11. Does the Center participate in teaching hypertension to medical students, house officers and fellows?
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Does the Center have a formal hypertension training program for fellows?
o How many fellows participate?
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Does the Center offer rotation for Nephrology, Cardiology and Endocrinology fellows?
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How do you train your non-physician personnel (Nurses, PharmDs, Physician Assistants, office assistants) in
hypertension management?
12. List the scholarly articles recently published within the last five (5) years by Center personnel related to the field of
hypertension and related disorders.
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Please submit the completed application, with any supporting documentation, along with the application fee of $4,500 (check or money order
payable to the American Society of Hypertension, Inc.). Centers will be invoiced for travel expenses for an on-site review if applicable.
Please note that this application fee is non-refundable.
* Designated Centers file an annual report during the period of designation (annual reporting fee: $500).
ASH Designated Hypertension Centers
American Society of Hypertension, Inc.
45 Main Street, Suite 712, Brooklyn, NY 11201
Telephone (212) 696-9099 • email: mtrifault@ash-us.org
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