Polygenic Risk Score Implementation and Stratification for Managing Blood Pressure

Inclusion Criteria: * Age 18 to 55 years (inclusive) at the time of screening. * Diagnosis of hypertension defined by 2017 ACC/AHA guidelines, as evidenced by Resting office systolic blood pressure (SBP) of 130-160 mm Hg or Resting office diastolic blood pressure (DBP) of 80-100 mm Hg or Current use of antihypertensive medication. * Poor cardiovascular health, defined as Life's Essential 8 score \<50. * Willing and able to undergo 24-hour ambulatory blood pressure monitoring (ABPM) to confirm hypertension. * Able to provide informed consent. Exclusion Criteria: * History of cardiovascular disease, including Myocardial infarction, Angina, Cardiac arrhythmia, Coronary heart disease, Heart failure, Stroke, or transient ischemic attack. * Body mass index (BMI) \<18.5 kg/m² or \>45 kg/m². * Baseline office SBP \>160 mm Hg or DBP \>100 mm Hg. * Use of more than two antihypertensive medication classes. * Not hypertensive based on 24-hour ABPM (per 2017 ACC/AHA criteria). * Pregnant or breastfeeding. * Estimated glomerular filtration rate (eGFR) \<60 mL/min/1.73 m² (using CKD-EPI equation). * Urine albumin-to-creatinine ratio ≥30 mg/g. * Hepatic transaminase levels \>3× the upper limit of normal. * Significant psychiatric illness (assessed via Global Health Questionnaire-12). * Moderate or severe anxiety (Beck Anxiety Inventory \[BAI\] score \>16).