Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: One of the most powerful predictors of stroke is hypertension, with estimates of approximately 33% of adults in the United States experiencing this condition.

Hypertension is very prevalent in the emergency department (ED), but significantly undertreated. The overall goal of this project is to develop a text messaging intervention to improve hypertension care in the ED. This will first be done by testing the feasibility of identifying hypertensive patients in the ED, and the response rate to text messages.


Options:
A: Inclusion Criteria:

* Diagnosis of type 2 diabetes mellitus (the onset of diabetes must have occurred on or after the age of 30 years and there is no history of diabetic ketoacidosis)
* Uncontrolled systolic hypertension (defined as a daytime systolic BP of 130 mm Hg or higher on 24-hour ambulatory)

Exclusion Criteria:

* Conditions making the patient unsuitable for study such as severe cognitive impairment, language difficulties (unable to speak and understand instructions in English), frequent (more than once per month for more than week) or prolonged (more than 2 months) trips away from home, homelessness, self-identified substance abuse, being pregnant, or unable to use home BP device;
* Life expectancy less than one year
* Coexisting conditions that require frequent (more than once a month) office visits or repeated (more than once in the past year) hospitalizations
* Atrial fibrillation or other cardiac arrhythmias requiring drug treatment
* Moderately severe chronic renal failure defined as estimated GFR less than 25 mL/min
* Myocardial infarction, episode of heart failure requiring hospitalization, or paralyzing stroke in the past year
* Having unstable angina
* Severe valvular heart diseases such as severe aortic stenosis
* Symptomatic orthostatic hypotension
* Refusal to sign consent form or to carry out the demands made by the study
B: Inclusion Criteria:

* Adult (≥18 y/o)
* At least one BP of systolic blood pressure (SBP) ≥160 or a diastolic blood pressure (DBP) ≥100 or only BP performed prior to enrollment is SBP ≥160 or a DBP ≥100 (If the patient has repeated measurements after achieving Criteria 1, but prior to being enrolled, at least one of the repeat BP remains SBP ≥140 or a DBP ≥90)
* Must have mobile phones with text-messaging capability
* Likely to be discharged from the ED

Exclusion Criteria:

* Adult who is in an urgent condition
* Unable to read
* Non-English speaking
* Incarcerated/ institutionalized resident
* Pregnant, or has a pre-existing condition that makes follow-up for 4 months unlikely.
C: Inclusion Criteria:

* Clinical diagnosis of hypertension and are either currently receiving or are about to start blood pressure lowering medication
* Mean blood pressure at enrolment is \< 175/105
* Aged 21 years or older
* Must have access to a cell-phone (shared access is allowed if access is daily and the phone owner agrees to participate)
* Must be able to use SMS-text (help by a partner is allowed for illiterate subjects, subjects with poor vision, or subjects who are learning disabled)
* Must be resident in the study area and must be expected to be resident for the duration of the study

Exclusion Criteria:

* Another member of the household has already been recruited into the trial
* If female, they are not pregnant or within three months post-partum by self-report
* They are not willing to give informed consent and take part in the study.
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: B