A Study in the Use of Home Blood Pressure Monitoring and Telephone Follow-up to Control Blood Pressure

• Blood pressure measured at home [ Time Frame: 6 and 12 months post randomization ] [ Designated as safety issue: No ]
• Compliance with use of home blood pressure monitor [ Time Frame: 6 and 12 months post randomization ] [ Designated as safety issue: No ]
• Number and type of antihypertensives prescribed [ Time Frame: 12 months post randomization ] [ Designated as safety issue: No ]
• Patient satisfaction and Quality of Life [ Time Frame: 6 and 12 months post randomization ] [ Designated as safety issue: No ]
• Primary care provider satisfaction with intervention [ Time Frame: 6 mo post randomization of a provider's first patient to enroll in the trial ] [ Designated as safety issue: No ]
• Number of primary care provider visits [ Time Frame: 12 months post randomization ] [ Designated as safety issue: No ]
• Number and quality of adverse events [ Time Frame: 3, 6, and 12 months post randomization ] [ Designated as safety issue: No ]
• cost analysis [ Time Frame: 12 months post randomization ] [ Designated as safety issue: No ]

The purpose of this study is to determine if the use of home blood pressure monitors plus nurse telephone monitoring is more effective than the use of blood pressure monitors alone in improving control of high blood pressure in an urban medical clinic.

• Device: Home blood pressure monitor
  Participants will receive a home blood pressure monitor and be taught how to use it. They will have an education session to review treatment goals, medications, diet and exercise. They will be asked to see their primary care provider at least every 3 months and the research nurse at 3, 6 and 12 months.
• Other: monitor and phone call
  Participants will receive all of the same interventions of the home monitoring group plus they will receive scheduled telephone follow up by the research nurse

• Active Comparator: home monitoring
  Intervention: Device: Home blood pressure monitor
• Experimental: monitor & phone call
  Intervention: Other: monitor and phone call

Inclusion Criteria:

• diagnosed with essential hypertension
• systolic blood pressure >140 mm Hg (130 if diabetic) OR diastolic blood pressure > 90 mm Hg (80 if diabetic)on at least 2 clinic visits prior to randomization
• BP at time of screening is > than systolic 140 (130 if diabetic) or diastolic 90 (80 if diabetic)
• patient is prescribed at least 1 antihypertensive medication
• Patient is fluent in English
• Patient is easily accessible by telephone

Exclusion Criteria:

• persons with stage 4 or 5 chronic kidney disease or end stage renal disease on dialysis
• Patients with a terminal illness
• Patients with severe dementia or serious mental illness
• Inability to preform self blood pressure monitoring
• Patient lacks a functioning home phone or personal cellular phone
• Pregnant or planning to get pregnant
• Arm circumference exceeds the allowable limit on the largest home BP monitor cuff