Patients with poorly controlled hypertension will have improved hypertensive control with telephone coaching and with telephone coaching combined with home-titration of medications.

Patients with poorly controlled hypertension are randomized to a control arm which receives telephone coaching or an active arm which receives telephone coaching plus intensification of medications via telephone coaching with the coaches using treatment algorithms approved by the patients' physician. These patients' blood pressure control will be compared with usual care patients in a passive arm (chart review only).

Inclusion Criteria:

• 2 blood pressure readings above 145/90.

Exclusion Criteria:

• Cognitive impairment,
• Short life expectancy,
• Creatinine greater than 1.5,
• Inability to check blood pressures at home.