Inclusion Criteria 1. English speaking male or female, 55 years of age or older, who has been seen at the site clinic within the last 24 months 2. Has a history of at least one of the following documented in the medical record Coronary artery disease Previous MI (heart attack) Stroke TIA Atrial fibrillation Systolic heart failure Peripheral vascular disease/claudication Carotid artery disease Diabetes mellitus with co-existing uncontrolled hypertension or hyperlipidemia Exclusion Criteria 1. Current signs of acute angina, stroke, heart failure or renal failure 2. Systolic blood pressure > 200 mmHg or diastolic blood pressure > 114 mmHg 3. Midpoint arm circumference > 50 cm 4. Significant hepatic disease, including: cirrhosis, hepatitis B or C infection, or laboratory abnormalities (serum ALT or AST > 3 times control or total bilirubin > 2.0 mg/dL) 5. Inability to give informed consent or impaired cognitive function 6. Nursing home residence 7. No access to telephone or inability to use a phone 8. Refusal to consider attempting to use the internet 9. Pregnant