No Is SBP 130 mm Hg or DBP 90 mm Hg? No Is the patient s blood pressure at or below goal? 17 Determine blood pressure goal (see Sidebar 4) Initiate treatment if drug na ve or optimize existing therapy (see Sidebar 5) Yes Consider offering and/or adjusting HBPM with co- interventions (tailored medication titration, education, and/or lifestyle counseling No Follow up periodically; reassess preferences Follow up regularly (e.g., monthly) until: Blood pressure is at goal Treatment regimen is optimized (see Sidebar 6) Comorbid conditions and/or other patient preferences direct otherwise No Follow up annually or more frequently as dictated by comorbid conditions (to include lab monitoring, if indicated) Yes Implement SDM to assess patient values and preferences; assess the need for and implement lifestyle modification Is the patient willing to engage in pharmacotherapy? 