Please select the eligibility criteria that correspond to the clinical trial below.
Title: Electronic Communications and Home Blood Pressure Monitoring
Brief Summary: The control of blood pressure (BP) for patients with hypertension on medications has been elusive, despite the availability of evidence-based nationally recognized guidelines for treatment and 30 years of research addressing this. At present, less than 50% of patients with known hypertension are adequately controlled. If BP control could be improved, significant decreases in cardiovascular morbidity and mortality would occur.

The purpose of this study is to conduct a randomized controlled trial of the effectiveness of the provision of home blood pressure measurement and electronic communications (secure messaging to health care providers) to improve hypertension control.


Options:
A: Inclusion Criteria:

* Age 18 to 85 years At least 1 diagnosis for hypertension,

  * Receive primary care from one of the participating clinics,
  * The two most recent BPs documented within that last 24 months are elevated (SBP\>140 and/or DBP\>90)
  * Receiving \< 3 antihypertensive medications, and
  * Have access to a computer with a USB port.

Exclusion Criteria:

* Pregnant, or breast-feeding,
* Patients on dialysis or being followed by nephrology,
* Patients with coronary artery disease, given these patients are already followed by the Clinical Pharmacy Cardiac Risk Service (CPCRS),
* On KPCO "Do Not Call" or deceased list,
* PCP does not give permission to include patient in the study,
* BP is at or below target at the baseline study visit,
* Not English-speaking.
B: Inclusion Criteria:

* 65 years or older taking 4 or more chronic medications independently living

Exclusion Criteria:

* assisted living or nursing home residents presence of any serious medical condition for which 1-year survival was expected to be unlikely
C: Inclusion Criteria:

* Patient aged 18 years and over followed at the Montreal Heart Institute's Anticoagulation clinic
* Warfarin treatment planned for at least 4 months after inclusion in the study
* Warfarin treatment initiated for at least 6 months
* Last 2 INRs between 1.5 and 4 if target INR is between 2 and 3
* Last 2 INRS between 2 and 4 if target INR is between 2.5 and 3.5
* Provide a signed informed consent

Exclusion Criteria:

* Patient unable to understand (spoken and written) French or English
* Patient refuses or is unable to attend the required training sessions
* Targeted INR other than 2 to 3 or 2.5 to 3.5
* Handicap or physical limitation compromising the patient's ability to initiate self-monitoring in the absence of a proxy helper
* Moderate to severe cognitive impairment or important comprehension problems
* Active neoplasm
* Concurrent chemotherapy
* Hypercoagulable conditions
* Life expectancy of less than 1 year documented in the medical chart
* Inclusion (at time of inclusion or 30 days prior to inclusion) in another research project involving a drug
* Patient anticoagulated with nicoumalone
* Pregnancy or breastfeeding
* Active bleeding (except for menses)
* Recent major bleeding (less than 3 months before inclusion)
* Stroke, acute coronary syndrome, percutaneous coronary intervention, coronary artery bypass graft, cardiac valve replacement, deep veinous thrombosis or pulmonary embolism in the 3 months prior to inclusion
* Any other condition that, in the opinion of the investigators, of the treating physician or of the healthcare professionals working at the anticoagulation clinic could make self-management by the patient impossible
D: Inclusion Criteria:

* Diagnosis of hypertension in the prior two years and on hypertension medications
* Access to the Internet and an e-mail address
* Ability to use a computer using the English language
* Medical care coverage which permits them to refill prescriptions at Group Health Cooperative pharmacies and a willingness to do so.
* Blood pressure on each of two screening visits averaging \> 90 mmHg diastolic or \> 140 mmHg systolic and \< 110 mmHg diastolic or \< 200 mmHg systolic

Exclusion Criteria:

* Diagnosed or history of diabetes, cardiovascular disease (ischemic heart disease, valvular heart disease, heart failure, arrhythmias, strokes or transient ischemic attacks, and peripheral vascular disease)
* Current treatment for cancer, on immunosuppressant or antiretroviral treatment.
* Surgery or hospitalization in the prior 3 months
* Pregnancy (or plans to become pregnant in the next 12 months)
* Plans to move out of the area or leave the health plan in the next 12 months.
* Upper arm circumference size \> 18 inches.
* Arrhythmia detected at screening visits

Answer: D