Please select the eligibility criteria that correspond to the clinical trial below.
Title: Comprehensive Approach for Hypertension Prevention and Control in Argentina
Brief Summary: The objective of this cluster randomized trial is to test whether a comprehensive intervention program within a national public primary care system will improve hypertension control among uninsured hypertensive patients and their families in Argentina.


Options:
A: Inclusion Criteria:

Patients must obtain their primary care at the Iowa City VAMC and have been diagnosed with Diabetes Mellitus and hypertension. Must be cognitively intact and have a telephone line in the home.

Exclusion Criteria:

Patients with corrected vision worse than 20/40 or cognitive impairment (Mini-Mental Status Exam score of 17 or less) will not be eligible.
B: Inclusion Criteria:

* Patients with the following cardiovascular conditions and respective medication classes:
* Hypertension (Beta-blockers \[B-blockers)\], Calcium Channel Blocker \[CCB\], Angiotensin converting enzyme inhibitors (ACEi), Angiotensin Receptor Blockers \[ARB\], or Thiazide diuretic)
* Hyperlipidemia (HMG CoA reductase inhibitor \[Statins\])
* Diabetes (Alpha-glucosidase inhibitors, Biguanides, DPP-4 inhibitors, Sodium glucose transport inhibitor, Meglitinides, Sulfonylureas, Thiazolidinediones, or statins Coronary artery disease P2Y12 inhibitor \[Clopidogrel, Ticagrelor, Prasugrel, Ticlopidine\], B-blockers, ACEi or ARB or statins)
* Atrial fibrillation (Direct oral anticoagulants, B-blockers, CCB)

Exclusion Criteria:

* Patients who do not have a mailing address listed in EHR;
* Patients who do not have a landline or cellphone listed in EHR;
* Currently pregnant if denoted in the EHR at the time of the data pull;
* Patients with a mailing address outside of the state of Colorado;
* Patients that do not speak either English or Spanish.
C: Inclusion Criteria:

* Age of 18 or greater
* At least one BP with Systolic Blood Pressure (SBP) ≥ 160 or a Diastolic Blood Pressure (DBP) ≥ 100 (criteria 1)
* If the patient has repeated measurements after achieving Criteria 1, at least one of the repeat BP remains SBP ≥ 140 or a DBP ≥ 90
* Must have cell phones with text-messaging capability and willingness to receive texts
* Likely to be discharged from the ED

Exclusion Criteria:

* Unable to read English (\<1% at study site)
* Prisoners
* Pregnant
* Pre-existing condition making one year follow-up unlikely

  * Terminal illness with death expected within 90 days
* Current use of 3 or more antihypertensive agents
* Patients with other serious medical conditions that prevent self-monitoring of BP
* Critical illness with placement in resuscitation bay
* Dementia/cognitive impairment
D: Inclusion Criteria for Clinics:

* The clinic is affiliated with the Remediar+Redes program.
* The clinic is located in urban poor areas according to the 2010 census data.
* The clinic has ≥1000 outpatient visits each month, so that sufficient participants can be recruited.
* The minimum distance between the selected clinics will be 10 kilometers to minimize the risk for contamination of the intervention.
* Physician visits and essential medications are free of charge to patients under all circumstances.
* The clinic has a high number of prescriptions for antihypertensive medications.
* The clinic employs community health workers.
* The clinic has general practitioners and nurses.
* The clinic has a history of good performance in the Remediar+Redes program.
* The clinic performs blood draws on patients when appropriate.

Inclusion Criteria for Participants:

* Patients aged ≥21 years who received primary care from the participating clinics and have hypertension ( SBP ≥140 mmHg and/or DBP ≥90 mmHg on at least 2 separate visits) and their spouses (with or without hypertension) and/or any adult hypertensive family members (age ≥21 years) living in the same household will be included.
* Hypertension patients and their spouses and/or family members must be available for the first baseline nurse home visit.
* The index patient must have a cell phone that receives text messages.
* The family's homes must be located within 10 kilometers from the clinic.

Exclusion Criteria for Participants:

* Hypertension patients who do not have a spouse or another adult with hypertension in the household.
* Plans to move from the neighborhood in the next two years
* Pregnant women or women who are planning to become pregnant in the next two years
* Persons who are bed-bound
* Persons who cannot give informed consent
* Persons with an arm circumference \>50 cm

Answer: D