Clinical Research Directory

Inclusion Criteria: * Systolic Blood Pressure (SBP) between 130 and 180 mm Hg: * 130 to 150 mm Hg (if on 0-4 medications) * 130 to 160 mm Hg (if on 0-3 medications) * 130 to 170 mm Hg (if on 0-2 medications) * 130 to 180 mm Hg (if on 0-1 medications) * Type 2 diabetes * To be considered as having a high cardiovascular risk, including AT LEAST ONE of the following factors: 1. Established cardiovascular disease (CVD), including: * Coronary artery disease: previous myocardial infarction, previous acute coronary syndrome, previous percutaneous coronary intervention, previous coronary artery bypass graft surgery, or at least 50% stenosis in a main coronary artery associated with typical angina pectoris; or * Cerebrovascular disease: previous stroke (except those events caused by intracranial aneurysm or arteriovenous malformation) or previous transient ischemic attack (TIA), stable for at least 2 weeks preceding inclusion in the study; or * Carotid artery disease: previous carotid endarterectomy, previous percutaneous intervention with carotid stent implantation, or stenosis of at least 50% in a carotid shown by the Doppler ultrasonography, CT angiography or MR angiography; or * Peripheral artery disease: prior surgical or percutaneous revascularization of a peripheral artery, limb amputation due to vascular cause, abdominal aortic aneurysm ≥ 5 cm (with or without prior surgical or percutaneous repair), or stenosis of at least 50% in a peripheral artery associated to intermittent claudication. 2. Subclinical CVD, including: * Coronary calcium score ≥ 300 Agatston units; or * Ankle-brachial index ≤ 0.90 in the last two years; or * Left ventricular hypertrophy on the electrocardiogram, echocardiogram or other cardiac imaging exam in the last two years. 3. Chronic kidney disease (CKD): ▪ Definition of CKD: glomerular filtration rate (GFR) between 20 and 59 ml/min/1.73m2 calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). 4. Additional cardiovascular risk factors, including: * Active smoking: Defined as regular use of cigarettes or other tobacco products, such as cigars and pipe, in the last six months; * Dyslipidemia: Defined as LDL cholesterol \> 70 mg/dL or non-HDL cholesterol \> 100 mg/dL in patients with previous CVD; or LDL cholesterol \> 100 mg/dL or non-HDL cholesterol \> 130 mg/dL in patients without previous CVD; or Triglycerides \> 200 mg/dL or HDL \< 40 mg/dL regardless of treatment; or use of statins or other lipid lowering medication; or * Age ≥ 75 years Exclusion Criteria: * Refusal to provide written informed consent * Body mass index \> 45 kg/m2 * Known secondary cause of hypertension * Severe renal dysfunction with GFR \< 20 mL/min/1.73m2 calculated by the CKD-EPI equation * Angina at rest Class IV Canadian Cardiovascular Society (CCS) * Acute coronary syndrome in the last six months * Symptomatic heart failure Class IV New York Heart Association (NYHA) or ejection fraction \< 35% on Doppler echocardiography in the last six months * Factors that at the research team´s judgment may limit adherence to the intervention and study protocol, including, but not limited to, the following examples: * Recent history of alcohol and illicit drug abuse * Psychiatric comorbidities (severe depression, schizophrenia, psychosis, etc.) * History of poor medication adherence and attendance to consultations * Any plans to move the city of residence in the next four years * Any plans to leave the city of residence for more than three months in the next few years * Living in the same residence of another patient previously included in this study * Patients currently enrolled in another study for CVD prevention, including those evaluating pharmacological and non-pharmacological interventions * Pregnancy or breastfeeding