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Government agencies (e.g., Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [JNC]), private medical societies (e.g., European Society of Hypertension--European Society of Cardiology [ESH--ESC]), and professional societies (e.g., American College of Cardiology, American Heart Association) agree that high blood pressure is a major independent risk factor for cardiovascular disease. Other major risk factors for cardiovascular disease include smoking, hyperlipidemia, diabetes, male gender, and older age. Results of clinical trials have indicated that target blood pressure control, as recommended by The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), can be maintained with medication adherence (Chobanian et al., 2003 ; Hynes & Sackett, 1976 ). Controlling individuals' blood pressures at the target goals recommended by JNC 7 and the World Health Organization--International Society of Hypertension (WHO--ISH) prevents target organ damage and reduces cardiovascular morbidity and mortality. Uncontrolled hypertension is defined as a systolic blood pressure greater than 140 mmHg or a diastolic blood pressure greater than 90 mmHg (Chobanian et al., 2003 ). For adults with diabetes and kidney disease, hypertension is defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg (Chobanian et al., 2003 ).
Findings from evidence-based studies led to the recommendation of home monitoring of blood pressure as a supplement to usual care in the guidelines developed by JNC 7 and the ESH--ESC (American College of Physicians, 1993 ; Chobanian et al., 2003 ; Fahey, Schroeder, & Ebrahim, 2005 ). For many years, office blood pressure readings have been the standard for diagnosing and managing hypertension, despite evidence that this method has limitations (Pickering, 2008 ). High readings taken in the provider's office do not usually constitute an emergency and repeated measurements on more than one occasion are needed for an accurate diagnosis. Frequent blood pressure monitoring away from the provider's office can be used to confirm a diagnosis or to monitor an individual's response to treatment; measurements can be taken with an inexpensive semi-automatic device or an expensive ambulatory blood pressure device (Chobanian et al., 2003 ). Although blood pressure management has been found to be positively influenced by...