Who this is for
Adults with elevated BP, dyslipidemia, or both. Members with hypertensive emergency, active acute coronary syndrome, or untreated severe arrhythmia are stabilized clinically before pathway start. Pregnancy-related hypertension routed to Maternal Health Pathway.
What brings people here
Office or home BP >=130/80; LDL >=130 (or risk-adjusted threshold); biometric screening flag; PCP referral following medication initiation.
Clinical framework
AHA-aligned (Life's Essential 8 framework); OneVillage-developed, delivered in partnership with the American Heart Association.
How the 8 weeks run
Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.
Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.
Re-score, refresh the care plan, and check in 1:1 on what is and is not working.
The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.
Final re-score, relapse prevention, and the plan for what happens next.
When your sessions fall
The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.
| Module | Weeks | Sessions | Cadence |
|---|---|---|---|
| Module 1 | Weeks 1 to 4 | 2 | every other week |
| Module 2 | Weeks 5 to 8 | 2 | every other week |
Week by week
- Before you beginBefore you begin
Set up home blood pressure monitoring and start recording. How to measure properly matters more than how often: wrong cuff size or a reading taken straight after coffee will send you and your doctor down the wrong road.
- Week 1DASH, sodium and potassium
The dietary evidence here is unusually strong because people were fed rather than advised, with body weight held stable. Blood pressure fell with the pattern, and fell further with each reduction in sodium.
- Week 2Movement and blood pressure
Including isometric work, which a large network meta-analysis found notably effective and which almost nobody has tried. Do not hold your breath during holds.
- Week 3Knowing your numbers
Targets, trends, and the trade-off that gets quoted without its caveats. One high reading is noise. A pattern across two weeks is information.
- Week 4Mid-program: what has moved
Compare your readings against week 0 as a trend. Then the adherence question, asked plainly, while there are four weeks left to do something about it.
- Week 5Alcohol and sleep
Two levers that are larger here than most people expect, and the two most often left out of the conversation. Sleep apnea is a common hidden cause of readings that will not come down.
- Week 6Stress and blood pressure
What is supported and what is overstated. Plus white coat and masked hypertension, which are the two reasons your home readings may be the more accurate picture.
- Week 7Your appointment list
Seven weeks of readings and a written list of questions. Most patients arrive with neither.
- Week 8Making it hold
These are managed rather than cured, so the only question is what continues. The three things that lapse first, and the tripwire that catches drift early.
Who you will work with
Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.
Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.
Melissa Tuell, MOT, OTR/L is a licensed Occupational Therapist with more than 30 years of experience helping people restore function, manage chronic conditions, and rebuild confidence in the activities that matter most to daily life.
Meet Lucy Paulise, who is a career and stress management coach, book writer, and Forbes contributor. Her passion lies in helping people discover and reach their full potential. She specializes in coaching individuals on how to manage stress, anxiety, imposter syndrome, perfectionism, or any other challenges they may face in their work or personal lives that can lead to feeling overwhelmed.
What we work on
| Domain | What this pathway does |
|---|---|
| Nutrition & Metabolism | DASH or Mediterranean. Sodium <2g/day; soluble fiber 10-25g; saturated fat <7% kcal; alcohol limits. |
| Movement & Mobility | 150 min/wk MVPA + 2x/wk resistance. Walking after meals especially effective. |
| Sleep & Recovery | Apnea screen mandatory in this pathway. STOP-BANG >=5 + ESS >=10 = same-day RN referral for PSG. |
| Stress & Resilience | Stress + BP coupling is direct. Daily relaxation practice. PSS-10 tracked q4 weeks. |
| Mind & Mood | PHQ-9 q4 weeks; depression doubles cardiac risk. |
| Preventive care | Annual physical, lipid panel, A1c, dental, eye exam. |
How progress is measured
These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.
| Tool | Cadence | Owned by |
|---|---|---|
| AHA Life's Essential 8 | Baseline, Wk 13-14, quarterly | WHC |
| Home BP series (7-day avg) | Daily in Build; biweekly in Maintain | WHC + member |
| Lipid panel | Baseline, Wk 13-14, quarterly | RN Nav coordinates |
| STOP-BANG + ESS | Onboard | Sleep Coach |
| PSS-10 | Onboard, q4 weeks | Stress Coach |
| PHQ-9 | Onboard, q4 weeks | WHC |
| Med-Diet Adherence Screener | Onboard, q4 weeks | Nutrition Coach |
The research behind this pathway
Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.
Guidelines this pathway follows
- 2025 AHA/ACC High Blood Pressure Guideline · American Heart Association and American College of Cardiology
Targets, home monitoring and when medication enters the conversation. PMID 40811516
- Life's Essential 8 · American Heart Association
The cardiovascular health score repeated at baseline, mid-program and exit. PMID 35766027
- DASH dietary pattern · NHLBI DASH trials
The eating pattern this pathway teaches. PMID 9099655
Key studies
- American Heart Association / American College of Cardiology (2025). Hypertension2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
The current AHA/ACC blood pressure guideline, and the source of the targets and the home-monitoring routine this pathway uses. PMID 40811516
- Appel LJ et al. (1997). N Engl J MedA clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group
459 adults ate one of three diets prepared for them. The DASH pattern lowered blood pressure by 5.5 over 3.0 mmHg more than the control diet, with no weight loss and no change in sodium. PMID 9099655
- Sacks FM et al. (2001). N Engl J MedEffects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group
412 people ate DASH or a control diet at three sodium levels. Cutting sodium lowered blood pressure further on top of the diet, and the two together did the most. PMID 11136953
- SPRINT Research Group (2015). N Engl J MedA Randomized Trial of Intensive versus Standard Blood-Pressure Control
9,361 people randomized to a systolic target under 120 rather than under 140. The tighter target cut cardiovascular events and deaths. PMID 26551272
- Cholesterol Treatment Trialists' Collaboration (2010). LancetEfficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials
170,000 people across 26 trials. Every further 1 mmol/L drop in LDL cholesterol cut major vascular events by about a fifth, with no threshold below which it stopped helping. PMID 21067804
- Cornelissen VA et al. (2013). J Am Heart AssocExercise training for blood pressure: a systematic review and meta-analysis
Pooled 5,223 people across the exercise trials. Endurance training lowered blood pressure by 8.3 over 5.2 mmHg in people who already had hypertension, several times the effect in people whose pressure was normal. PMID 23525435