This nurse practitioner-led quality improvement (QI) study was designed to improve clinical performance in hypertension (HTN) management that focused on self-management support (SMS) among adult patients at a primary care clinic with a high rate of cardiovascular disease. The design included retrospective baseline of meaningful use population data (N=1,210) generated six months prior to study start date and an analysis of the data during the six-month QI study (N=1,409). Interventions included staff QI training along with patient education and lifestyle goal setting for SMS of HTN. Electronic medical record data included blood pressure, cholesterol, tobacco use, body mass index, and self-management goals. The primary objective, >80% of adults would have documented self-management goals, was achieved and significantly improved from baseline. Nurse practitioners have an important role in meeting the current demand for HTN management in primary care and supporting patients in self-management. Keywords: Cardiovascular disease, Hypertension, Primary care, Quality Improvement, Self-managemen