H. Screening for Asymptomatic Hypertension-mediated Target Organ Damage Despite clinically sound concerns about target organ damage resulting from HTN and routine screening for asymptomatic CVD and kidney disease that is done by many general practitioners, there is a paucity of evidence to support this practice. Future studies are needed to evaluate cost effectiveness and clinical impact of routine screening for asymptomatic target organ damage in hypertensive individuals. For example, coronary artery calcification (CAC) score carries prognostic value in hypertensive patients. However, additional research should address whether CAC scores can direct initiation of antihypertensive therapy and dictate individualization of blood pressure management and goals. Appendix A: Evidence Review Methodology A. Developing the Scope and Key Questions The CPG Champions, along with the Work Group, were tasked with identifying KQs to guide the systematic review of the literature on HTN. These questions, which were developed in consultation with the Lewin Team, addressed clinical topics of the highest priority for the VA and DoD populations. The KQs follow the population, intervention, comparison, outcome, timing and setting (PICOTS) framework for evidence questions, as established by the Agency for Healthcare Research and Quality (AHRQ). Table A-1 provides a brief overview of the PICOTS typology. PICOTS Element Description Population, Patients, or Problem A description of the patients of interest. It includes the condition(s), populations or sub- populations, disease severity or stage, co-occurring conditions, and other patient characteristics or demographics. Intervention or Exposure Refers to the specific treatments or approaches used with the patient or population. It includes doses, frequency, methods of administering treatments, etc. Comparison Describes the interventions or care that is being compared with the intervention(s) of interest described above. It includes alternatives such as placebo, drugs, surgery, lifestyle changes, standard of care, etc. Outcome Describes the specific results of interest. 