Patient case (clinical description): A 67-year-old woman comes to the clinic due to recent episode of choking, dysphagia, and cough.  Her other medical problems include hypertension, dyslipidemia, and osteoarthritis.  She does not smoke or use alcohol. She lives with her husband and she is able to do her own daily activities. She used to teach elementary school. Blood pressure is 135/80 mm Hg.  The patient's breath smells bad. Other physical examinations are normal.  A barium swallow study reveals an abnormality in the upper esophagus with an outpouching at the junction of the lower part of the throat and the upper portion of the esophagus.

Patient's own account: I'm a 67-year-old lady, and I went to the clinic due to nonstop choking, difficulty swallowing, and coughing. I also suffer from hypertension, cholesterol, and osteoarthritis. I do not smoke or drink alcohol. I live with my husband, and we are independent retired elementary school teachers. During the exam, my blood pressure was 135/80 mm Hg. The doctor told me I had a smelly breath. How embarrassing! The rest of my physical exam was normal. I did a barium swallow test, which is an X-ray of my throat, which revealed a problem in the upper part of my esophagus, where there's a small pouch or bulge at the spot where my throat meets the esophagus.

Clinical trial: MI-BP: mHealth to Improve Blood Pressure Control in Hypertensive African Americans

Eligibility criteria:
Inclusion Criteria:

          -  African American

          -  Hypertensive

          -  Owning a compatible smartphone

          -  Presenting to the Detroit Medical Center Detroit Receiving, Sinai-Grace Hospital, or
             selected Community Health Screening Events with, but not necessarily for, uncontrolled
             blood pressure (systolic blood pressure ≥ 135 mm Hg at triage and on repeat
             measurement using the BpTRU device).

        Exclusion Criteria:

          -  No self-reported prior history of hypertension

          -  No hypertension diagnosis documented in their medical record

          -  Non-English speaking

          -  Presenting with an acute illness necessitating immediate medical intervention

          -  Presenting with an admission to the hospital for critical reasons (as determined by
             the attending physician)

          -  Pregnant (as determined by a dip test at screening), or self-report during trial.

          -  Having the following serious comorbidities or confounders due to the fact that they
             may make blood pressure control difficult or necessitate frequent Emergency Department
             use or hospitalization:

               -  Previous diagnosis of resistant hypertension (or current use of 3 or more
                  maximally dosed antihypertensive agents without achievement of blood pressure
                  control)

               -  Steroid dependent asthma or emphysema

               -  Cirrhosis or hepatic failure

               -  Chronic heart failure (any stage)

               -  Previous diagnosis of acute myocardial infarction, angina (stable or unstable),
                  or known coronary artery disease

               -  Previous diagnosis of cerebrovascular disease (including transient ischemic
                  attack or stroke)

               -  Known valvular heart disease

               -  Stage IV or V chronic kidney disease

               -  Cancer (terminal or undergoing active chemotherapeutic or radiation therapy)

          -  Patients with other serious medical conditions that may affect their ability to
             self-monitor blood pressure (such a dementia)

          -  Having a history of alcohol or drug abuse as determined by the CAGE-AID questionnaire
             (excluded if 2 or more)

          -  Week 2 measurement of systolic blood pressure < 130 mm Hg using the BpTRU device
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 25 Years old.
Subject must be at most 70 Years

Eligibility (NLI label): Contradiction