Antihypertensive Self-titration in US Primary Care

The objective of this study is to pilot test self-titration intervention procedures. We are testing a new way to manage high blood pressure from home. In this study, patients will check their blood pressure at home and take steps to adjust their blood pressure medications if needed, following a plan outlined with a primary care doctor. Participation in this study will last up to 6 months. Participation will include a research visit to review the blood pressure management process. A primary care provider will also develop a medication plan for each participant to follow during the study and address any questions at their upcoming visit. During the study, each participant will be asked to check their blood pressure at home every day for 1-2 weeks a month using a study-provided blood pressure cuff. They will be asked to follow a set of instructions to request a medication change from their provider, based on their blood pressure readings. Participation may also include lab visits and additional visits with a primary care physician before making medication changes, if needed. There will also be a follow-up visit within 6 months.

Inclusion Criteria: * Age ≥35 years * Prescribed 1 or 2 antihypertensives * Average of last 3 BPs \> 130/80 (home \& clinic) * Upcoming scheduled PCP visit * Averaged BP \>130/80 at nurse visit Exclusion Criteria: * Unable to read English or Spanish * Unable to self-monitor (by nurse assessment) * Dementia or significant cognitive impairment (nurse / PCP discretion) * Pregnant or actively seeking to become pregnant * Terminal diagnosis or hospice * Family member already participating in the trial