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Abstract-The relationship between encounter frequency (average number of provider-patient encounters over a period of time) and blood pressure for hypertensive patients is unknown. We tested the hypothesis that shorter encounter intervals are associated with faster blood pressure normalization. We performed a retrospective cohort study of 5042 hypertensive patients with diabetes mellitus treated at primary care practices affiliated with 2 academic hospitals between 2000 and 2005. Distinct periods of continuously elevated blood pressure (Ն130/85 mm Hg) were studied. We evaluated the association of the average encounter interval with time to blood pressure normalization and rate of blood pressure decrease. Blood pressure of the patients with the average interval between encounters Յ1 month normalized after a median of 1.5 months at the rate of 28.7 mm Hg/month compared with 12.2 months at 2.6 mm Hg/month for the encounter interval Ͼ1 month (PϽ0.0001 for all). Median time to blood pressure normalization was 0.7 versus 1.9 months for the average encounter interval Յ2 weeks versus between 2 weeks and 1 month, respectively (PϽ0.0001).In proportional hazards analysis adjusted for patient demographics, initial blood pressure, and treatment intensification rate, a 1 month increase in the average encounter interval was associated with a hazard ratio of 0.764 for blood pressure normalization (PϽ0.0001). Shorter encounter intervals are associated with faster decrease in blood pressure and earlier blood pressure normalization. Greatest benefits were observed at encounter intervals (Յ2 weeks) shorter than what is currently recommended. (Hypertension. 2010;56:68-74.)Key Words: hypertension Ⅲ encounter frequency Ⅲ visit frequency Ⅲ outcomes E levated blood pressure is one of the major risk factors for macrovascular and microvascular complications in diabetic patients. 1-7 Treatment of hypertension decreases these risks 8 -12 and is highly cost-effective. 13,14 Despite abundant evidence of the benefits of lowering blood pressure, most patients with diabetes mellitus do not reach evidence-based treatment goals. [15][16][17] The reasons for this are not well understood.Current guidelines recommend that patients be followed up within a month when an elevated blood pressure is noted. 18 However, the intervals between provider-patient encounters are substantially longer. 19 -23 It is possible that this discrepancy between the guidelines and the practice of medicine contributes to the suboptimal outcomes in patients with hypertension. The currently available evidence on the relationship between encounter intervals and blood pressure is conflicting. Although a study of 400 patients by Guthmann et al 23 found a correlation between return visit interval and percentage of change in blood pressure, a smaller study of 100 patients by Parchman et al 24 failed to detect a statistically significant relationship. Furthermore, there are no data to provide guidance with respect to the optimal encounter interval for blood pressure control, and t...