MI-BP: mHealth to Improve Blood Pressure Control

Inclusion criteria

• Detroit-area residents
• Hypertensive
• Owning a compatible smartphone
• Presenting to the Detroit Medical Center Detroit Receiving, Sinai-Grace Hospital, or selected Community Health Screening Events with, but not necessarily for, uncontrolled blood pressure (systolic blood pressure ≥ 135 mm Hg at triage and on repeat measurement using the BpTRU device).

Exclusion criteria

• No self-reported prior history of hypertension
• No hypertension diagnosis documented in their medical record
• Non-English speaking
• Presenting with an acute illness necessitating immediate medical intervention
• Presenting with an admission to the hospital for critical reasons (as determined by the attending physician)
• Pregnant (as determined by a dip test at screening), or self-report during trial.
• Having the following serious comorbidities or confounders due to the fact that they may make blood pressure control difficult or necessitate frequent Emergency Department use or hospitalization:

• Previous diagnosis of resistant hypertension (or current use of 3 or more maximally dosed antihypertensive agents without achievement of blood pressure control)
• Steroid dependent asthma or emphysema
• Cirrhosis or hepatic failure
• Chronic heart failure (any stage)
• Previous diagnosis of acute myocardial infarction, angina (stable or unstable), or known coronary artery disease
• Previous diagnosis of cerebrovascular disease (including transient ischemic attack or stroke)
• Known valvular heart disease
• Stage IV or V chronic kidney disease
• Cancer (terminal or undergoing active chemotherapeutic or radiation therapy)
• Patients with other serious medical conditions that may affect their ability to self-monitor blood pressure (such a dementia)
• Having a history of alcohol or drug abuse as determined by the CAGE-AID questionnaire (excluded if 2 or more)
• Week 2 measurement of systolic blood pressure < 130 mm Hg using the BpTRU device or study-issued BP cuff.