Hypertension

Lifestyle Modification

Not at Goal BP (<140/90 mmHg or <130/80 mHg for those with Diabetes or Chronic Kidney Disease)

Weight reduction, DASH eating plan, sodium restriction, physical activity, moderation of alcohol consumption

Drug(s) for the Compelling Indications
Other Antihypertensive Drugs (Diuretics ACE inhibitor or ARB or beta-blocker or CCB) as needed

Not at Goal BP

Initial Drug Choices

Hypertension without Compelling Indications

Hypertension with Compelling Indications

Stage 1 Hypertension
SBP 140-159 mmHg or DBP 90-99 mmHg

Thiazide-Type Diuretics for Most
May consider ACE inhibitor, ARB, beta-blocker, CCB or Combination

Stage 2 Hypertension
SBP≥160 mmHg or DBP≥100 mmHg

2-Drug Combination for Most
Usually Thiazide-Type Diuretic and ACE inhibitor or ARB or beta-blocker or CCB

Optimize dosage or add Additional Drugs until Goal BP is Achieved
Consider Consultation with Hypertension Specialist

End

Heart failure, post-myocardial infarction, high coronary disease risk, diabetes, chronic kidney disease, recurrent stroke prevention