A. Module A: Screening and Diagnosis Abbreviations: ABPM: ambulatory blood pressure monitoring; CV: cardiovascular; DBP: diastolic blood pressure; EKG: electrocardiogram; HBPM: home blood pressure monitoring; HTN: hypertension; SBP: systolic blood pressure B. Module B: Treatment Abbreviations: HBPM: home blood pressure monitoring; HTN: hypertension; SDM: shared decision making Sidebar 1: Office Blood Pressure Measurement See Appendix G of the full HTN CPG for appropriate blood pressure cuff selection, patient preparation, and proper technique AOBP (preferred) Fully automated machine programmed to wait five minutes and record the average of three measurements separated by at least 30 seconds Standard Technique (alternative) Use a properly calibrated and validated sphygmomanometer Use an average of >2 readings Abbreviations: AOBP: automated office blood pressure; CPG: clinical practice guideline; HTN: hypertension Sidebar 2: Confirm Diagnosis If the follow-up clinic blood pressure value is >130 mm Hg SBP or >90 mm Hg DBP, make diagnosis of HTN without further testing Consider HBPM or ABPM to inform the diagnosis in select patients (see Recommendation 4) If blood pressure is <130 mm Hg SBP and <90 mm Hg DBP, yet there is evidence of target organ damage, which may suggest the presence of masked HTN, consider HBPM or ABPM to inform the diagnosis (see Abbreviations: ABPM: ambulatory blood pressure monitoring; DBP: diastolic blood pressure; HBPM: home blood pressure monitoring; HTN: hypertension; SBP: systolic blood pressure Sidebar 3: Examples of Target Organ Damage and Comorbid Conditions* Target organ damage: stroke, MI, peripheral arterial diseases, LVH, CHF, CKD, and retinopathy Comorbid conditions: CKD, dyslipidemia, diabetes, obesity/overweight, OSA, and tobacco dependence *If patient has comorbid conditions, engage relevant VA/DoD CPGs, when available (e.g., CKD5 , ) Abbreviations: CHF: chronic heart failure; CKD: chronic kidney disease; CPGs: clinical practice guidelines; LVH: left ventricular hypertrophy; MI: myocardial infarction; OSA: obstructive sleep apnea Sidebar 4: Goals for Blood Pressure Systolic Goal (see Recommendations 6 8) <130 mm Hg If less stringent goal is desired per clinical judgment and/or patient preferences, aim for at least: <150 mm Hg for patients age 60 and over <140 mm Hg for patients age 60 and over with type 2 diabetes Diastolic Goal (see Recommendation 9) <90 mm Hg for patients age 30 and over 5 See the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease. 