Intensive Blood Pressure Control During Cardiotoxic Breast Cancer Treatment (PROTECT), A Randomized Controlled Trial

Inclusion Criteria: * Age ≥ 18 years * Female assigned at birth * Biopsy proven breast cancer (stage I-IV) * Treatment with therapy anthracycline-based chemo (with or without HER2-targeted therapy), with \>/= 2 cycles of anthracycline chemotherapy planned. * SBP ≥130 mm Hg * Willing and able to comply with the requirements of the protocol. * Participant must have and be willing to use their bluetooth enabled wifi or cellular mobile device * (For participants in the CPET cohort): Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria: * Achieving a plateau oxygen consumption, concurrent with an increase in power output; * A respiratory exchange ratio ≥ 1.10; * Attainment of maximal predicted heart rate, as defined by a peak heart rate within 10bpm of the age predicted maximal heart rate (220 - Age\[years\]); * Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale. Exclusion Criteria: * eGFR \< 30 ml/min/1.73m2 (based upon Cockcroft-Gault, etc.) * Individuals with arm circumference too large to allow accurate BP measurement with available BP devices * Inability to accurately measure blood pressure in at least one arm (e.g., bilateral upper extremity lymphedema) * Cardiac comorbidity, including any of the following: * Acute coronary syndrome within 3 months prior to randomization. * Symptomatic heart failure (NYHA class III/IV) within past 6 months * History of stroke * Cardiac transplantation * Other medical disorder or condition that in the opinion of the investigator would impair the subject's ability to participate or adhere to study interventions * (For participants in the CPET cohort): Subjects must not have any of the following absolute contraindications to cardiopulmonary exercise testing: * Acute myocardial infarction (within 30 days of any planned study procedures), * Unstable angina * Uncontrolled arrhythmias causing symptoms or hemodynamic compromise, * Symptomatic severe aortic stenosis * Recurrent syncope * Active endocarditis * Acute myocarditis or pericarditis * Acute pulmonary embolus or pulmonary infarction (within 3 months of any planned study procedures) * Thrombosis of lower extremities (within 3 months of any planned study procedures) * Suspected dissecting aneurysm * Uncontrolled asthma * Pulmonary edema * Room air desaturation at rest ≤85% * Respiratory failure * Acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis) * Mental impairment leading to inability to cooperate.