A Behavioral Intervention To Improve Hypertension Control In Veterans

Inclusion Criteria:

• Patients receiving continuity of care in the outpatient clinics will be eligible. This will be operationalized as 2 visits in the previous year.
• Adults (= 21 years) with hypertension, on antihypertensive medication for = 1 year, and who have current uncontrolled BP will be enrolled.

Patients with CVD:

• chronic stable angina
• unstable angina
• uncomplicated myocardial infarction
• coronary artery bypass surgery
• percutaneous coronary angioplasty
• atherectomy or stent placement
• chronic stable angina pectoris
• stable Class I or Class II congestive heart failure
• stroke
• peripheral vascular disease

will be entered into the study if the CVD event or diagnosis occurred = 6 months ago.

Exclusion Criteria:

Patients with limited life expectancy (< 1 year) due to severe co-existing non-CVD disease such as:

• terminal illnesses such as terminal cancer
• CVD < 6 months ago
• Class III or IV CHF
• severe psychiatric illness such as psychosis
• manic depression
• alcohol abuse (> 21 drinks/week)
• serious chronic conditions like AIDS
• tuberculosis
• lupus
• and end-stage renal failure

will be excluded.

• Other exclusions include inability to understand English
• Lack of a landline telephone
• Unable to follow the study protocol
• Recent major surgery (< 3 months)
• Patients who are temporarily in the area and plan to move in < 1 year or will not be available for follow-up
• Those unable to provide informed consent.
• All patients excluded and reason for exclusion will be recorded.
• Prior to recruitment, each patient will be informed about the study and informed consent obtained.