# Self-management of blood pressure medication for hypertensive veterans

> **NIH VA I01** · VA SAN DIEGO HEALTHCARE SYSTEM · 2020 · —

## Abstract

Anticipated Impact on Veterans’ Healthcare: Hypertension is the most common medical problem
among US Veterans. Treatment is available and effective, but control rates remain under 75%. While
blood pressure control has traditionally been achieved through sequential visits and medication
changes initiated by providers during office-based care, self-monitoring and self-management of
blood pressure medication is an important strategy that would empower Veterans to achieve better
control of blood pressure. The health impacts of better systems for treatment of hypertension are
significant, including decreased rates of cardiovascular and kidney disease.
Project background: Recent literature from the UK (TASMINH2 and TASMIN-SR trials) have
suggested that patient-driven self-management of blood pressure medications can be effective in
achieving hypertension control, but questions remain as to how to apply these findings to a US
population. The VA Healthcare System is an ideal system in which to test and customize this
strategy for blood pressure treatment.
Project objectives:
We propose to address the following simple and powerful clinical research question:
Is patient-initiated self-management of blood pressure medication using a pre-specified, generalizable
dose escalation scheme clinically effective, safe, and acceptable to patients and clinicians, compared
to usual care in controlling blood pressure in hypertensive veterans?
Project methods: We propose a 12-month randomized, controlled, non-blinded, single-center study
of patient-initiated self-management of blood pressure medication vs. usual care with planned post-
study cohort follow-up via medical records. Participants in the intervention arm will be provided with
home blood pressure monitoring tools and a self-management algorithm for changing their blood
pressure medications as needed. Participants in the usual care arm will receive home monitoring
tools and typical hypertension care from the primary care provider. The primary blood pressure
outcome measure for the study will be between-group change in in-clinic blood pressure.
Acceptability, safety, patient-centered outcomes and adherence will be key secondary outcomes.

## Key facts

- **NIH application ID:** 9955043
- **Project number:** 5I01HX002109-03
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Dena Evette Rifkin
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9955043

## Citation

> US National Institutes of Health, RePORTER application 9955043, Self-management of blood pressure medication for hypertensive veterans (5I01HX002109-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9955043. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*