Table 2.

Sample recommendations and tailored messages for subjects not adherent to recommendation.

Recommendation from JNC7	Message
The blood pressure should be controlled to less than 130/80 in patients with diabetes or chronic kidney disease and to less than 140/90 in others.	WHAT CAN YOU DO TO HELP ME LOWER MY BLOOD PRESSURE? Your blood pressure is too high. The goal for your top number is less than 130, and the goal for your bottom number is less than 80. Your current blood pressure of 152 over 94 puts you at risk for stroke, heart attack, and kidney damage. You need to keep BOTH numbers under control. Your doctor can give you one or more medicines, increase the dose of your medicines, or refer you to a blood pressure specialist. Your doctor should keep making changes in your care until your blood pressure numbers get to the goal.
Physicians should discuss medication adherence.	WHAT KIND OF ROUTINE WOULD HELP ME TO TAKE MY MEDICINES EACH DAY? From what you’ve told us, you don’t have a routine for taking your medicine. It is very helpful to take your medicines the same way each day. Some people buy a pillbox or use a timer or take their medicine when they brush their teeth. Your doctor may have other helpful ideas. It is important that you find some routine, as it will help you to control your blood pressure.
Physicians should address barriers to adherence.	SHOULD A BLOOD PRESSURE MEDICINE BE CHANGED TO ONE THAT DOESN’T BOTHER ME? From what you’ve told us, a blood pressure medicine may be bothering you. It is often hard to know what is causing bothersome symptoms. They may or may not be from a medicine. Your doctor may do one of the following: Change the dose of a medicine Change you to a different medicine Change how or when you take a medicine
Physicians should discuss lifestyle changes.	WHAT LIFESTYLE CHANGES WOULD HELP TO CONTROL MY BLOOD PRESSURE? Lifestyle changes can help people lower their blood pressure. Weight loss, regular exercise and eating less salt, more fruits, vegetables and low-fat dairy products have all been proven to help. You should talk to your doctor about which of these changes may be most helpful for you.
Follow-up should be at least each month until blood pressure is controlled.	SHOULD I BE SEEN MORE FREQUENTLY UNTIL MY BLOOD PRESSURE IS CONTROLLED? From what you’ve told us, your blood pressure is not controlled and your next visit is more than 2 months away. You should talk to your doctor about this. You shouldn’t go more than 2 months without seeing your doctor if your blood pressure is not controlled. You may want to call to make an appointment that is sooner than the one that is planned.
Serum creatinine and potassium should be monitored regularly.	AM I DUE TO HAVE A BLOOD TEST FOR CREATININE AND POTASSIUM? At least once every year, people with high blood pressure should have a blood test for creatinine and potassium. People with high blood pressure are at high risk for kidney damage. People with more creatinine and potassium in the blood need to have their blood pressure controlled more closely.