Initial clinical encounter with the patient with established hypertension.

The initial encounter with the patient with hypertension presents the opportunity to reprogram the trajectory of overall cardiovascular risk in the patient with suspected or established hypertension. The practicing clinician should strive to recognize other important considerations beyond drug prescription and treatment guidelines, such as the patient's level of health literacy, social and economic implications of lifelong drug therapy and health care costs, and readiness for and effectiveness of patient self-management. This should be followed by delivery of patient education that is appropriate for literacy level. Self-monitoring should be a tool to engage patients in active participation. Comprehensive risk stratification should be encouraged in all patients. Careful clinician adherence to established practice guidelines in overall risk assessment and treatment and control of blood pressure to target levels remain crucial.