1. Any clinical cardiovascular disease (e.g., coronary artery disease, heart failure, stroke, arrhythmia)

2. Chronic kidney disease or glomerular filtration rate \<60 ml/min on screening laboratory testing

3. Diabetes or HbA1c ≥ 6.5% on screening laboratory testing

4. LDL-C ≥ 190 mg/dL on screening laboratory testing (on or off medications)

5. ASCVD risk score calculated ≥ 10% for 10 years by clinical calculator on screening (if stage-1 systolic HTN only)2

6. Inability or not willing to follow-up with PAL2 research or usual care limb and at 6 \& 12-months at the MHU

7. Taking any medications for diabetes, heart disease or kidney disease. Cholesterol medication is not an exclusion

8. Inability to understand and sign informed consent

10\. Chronic condition (e.g., cancer) with a potential life expectancy \< 2 years

Linkage, Empowerment, and Access to Prevent Hypertension