OBJECTIVE: Recognizing high blood pressure (BP) as the most prevalent cardiovascular risk factor in rheumatology patients and all adults, experts recommend clinic protocols to improve BP control. We aimed to adapt and implement a specialty clinic protocol, BP Connect, to improve timely primary care follow-up after high BPs in rheumatology clinics. METHODS: We examined BP Connect in a six-month pre- post- quasi-experimental design with 24-month follow-up in three academic rheumatology clinics. Medical assistants and nurses were trained to (1) check, re-measuring BPs ≥140/90, (2) advise, linking rheumatic and cardiovascular diseases, and (3) connect, timely (textless4 weeks) primary care follow-up using protocolled electronic health record (EHR) orders. We used EHR data and multivariable logistic regression to examine the primary outcome of timely primary care follow-up for patients with in-network primary care. Staff surveys assessed perceptions. Interrupted time-series analysis examined sustainability and clinic population BP trends. RESULTS: Across both 4,683 pre-implementation and 689 post-implementation rheumatology visits with high BP, 2,789 (57%) were eligible for in-network primary care follow-up. Post-implementation, the odds of timely primary care BP follow-up doubled (OR 2.0, 95% CI 1.4-2.9). Median time to follow-up declined from 71 to 38 days. Moreover, rheumatology visits with high BP declined from 17% to 8% over 24-months, suggesting significant population-level declines (ptextless0.01). CONCLUSION: Implementing the BP Connect specialty clinic protocol in rheumatology clinics improved timely follow-up and demonstrated reduced population-level high BP rates. Findings highlight a timely strategy to improve BP follow-up amid new guidelines and quality measures. This article is protected by copyright. All rights reserved.