Coaching and Navigation by Community Health Workers (CHWs) Through Telehealth for High-risk Hypertension

The investigators propose an intervention that leverages the success of Community Healthcare Workers (CHWs) and telehealth to connect patients with severe hypertension from Emergency Department (ED) to primary care resources and to coach them to adopt evidence-based, practical lifestyle solutions relevant to urban living. The investigators have proposed this intervention as "Coaching and Navigation by Community Health Workers (CHWs) through Telehealth for High-risk Hypertension: CONNECT-HTN intervention. The investigators hypothesize that participants receiving the CONNECT-HTN intervention will have a lower likelihood of experiencing a major cardiac event compared with those referred to clinic-based care.

Inclusion Criteria: Eligible patients * Must be over the age of 18 years * Have an ED triage SBP ≥ 180 and/or DBP ≥ 110, with a repeat similar reading ≥30 minutes after triage * May have received treatment for elevated BP, but must have no evidence of end-organ damage (defined as dialysis dependence, acute stroke, acute coronary syndrome, acute kidney injury, or papilledema) * Have a functional status of either fully active (independent in daily activities) or mildly restricted but ambulatory and able to work (washing, toileting, dressing, feeding, mobility). * May be admitted for deranged BP only with no complications, or may be stable for discharge per treating emergency physician * Include referrals from the clinic to the ED with SBP/DBP values in the inclusion range * Can provide informed consent. Intervention is accessible to individuals of all literacy levels * Can receive phone calls and in-person visits. Smartphone ownership not required (intervention compatible with analog phones) Exclusion Criteria: Given that hypertension is defined and treated differently, we will exclude * pregnant patients * terminally ill patients, as well as * those requiring admission to the hospital due to severe complications (other than deranged BP).