See the VA/DoD Clinical Practice Guideline for Screening and Management of Obesity and Overweight. Available at: https://www.healthquality.va.gov/guidelines/CD/obesity/ Sidebar 4: Goals for Blood Pressure Systolic Goal (see Recommendations 6 8 in the full CPG) <130 mm Hg If less stringent goal is desired per clinical judgment and/or patient preference, aim for at least: <150 mm Hg among patients age 60 and over <140 mm Hg for patients age 60 and over with type 2 diabetes Diastolic Goal (see Recommendation 9 in the full CPG) <90 mm Hg for patients age 30 and above Obtain office blood pressure (see Sidebar 1) 1 Adult in healthcare system Go to Module B, Yes Return after acute episode resolved (typically within 4 weeks) Yes Yes Yes No No Assess the need for and implement lifestyle modification, then follow up for adherence (e.g., diet, exercise, weight loss, alcohol moderation) Screen blood pressure periodically; address other CV risk factors (including healthy diet and physical activity); in patients with known or suspected target organ damage (see Sidebar 3), consider possibility of masked HTN (consider HBPM or ABPM) No Yes Obtain history and physical and assess for target organ damage and comorbid conditions (see Sidebar 3); consider baseline testing (e.g., basic metabolic panel, urinalysis, EKG, A1c, other tests) as appropriate Yes Evaluate as indicated; consider referral Yes Initiate treatment (go to Module B) When measured properly (see Appendix G in the full CPG), is SBP 120 mm Hg or DBP 80 mm Hg? Is the patient currently being treated for HTN? Confirm diagnosis of HTN by measuring blood pressure after 1 4 weeks (see Sidebar 2); is diagnosis confirmed? Does patient have an acute injury or illness? Is secondary cause suspected? No Is SBP 130 mm Hg or DBP 90 mm Hg? 