e 2020 Recommendation column: For recommendations that were carried forward to the 2020 VA/DoD HTN CPG, this column indicates the new recommendation(s) to which they correspond. 2014 Recommendation Text 2014 Strength of Recommendation Recommendation Category Recommendation Section Number Page For patients whose diagnosis of hypertension remains uncertain, we suggest offering 24-hour ambulatory blood pressure monitoring as an alternative to home blood pressure monitoring to confirm diagnosis prior to beginning pharmacologic treatment. Weak for Reviewed, New- replaced We suggest offering a multi-modal approach to adherence interventions, which could include telemonitoring, multi-disciplinary group medical appointments, (e.g., shared medical appointments), case management (by pharmacists, nurses, social workers), patient and provider education, behavioral therapy, etc. Weak for Reviewed, New- replaced We recommend offering lifestyle modification interventions for patients with prehypertension or hypertension based on patient indications and preferences as well as assessment of available local resources. (Modified from 2004 VA/DoD HTN CPG) Strong for Reviewed, Amended We recommend discussing healthy weight range and advising overweight or obese hypertensive patients to reduce their body mass index to below 25. (Modified from 2004 VA/DoD HTN CPG) Strong for Reviewed, Deleted If a normal body mass index (<25) cannot be achieved, we suggest advising patient that a weight reduction of at least 10 pounds can achieve a decrease in blood pressure. Weak for Not reviewed, Deleted We recommend a target for aerobic exercise of 30 to 45 minutes per session, at least four times per week. (Modified from 2004 VA/DoD HTN CPG) Strong for Not reviewed, Amended We suggest the use of a self-monitoring device (e.g., pedometer, mobile apps, etc.) to increase adherence to physical activity. Weak for Reviewed, Deleted For patients interested in complementary and alternative medicine, we suggest considering mind-body therapies such as transcendental meditation or yoga. 