HYPERTENSION

2 elevated readings on at least 2 clinic visits over a period of 1 to several weeks.

SBP 140 mmHg or DBP 90 mmHg
Treatment SHOULD BE started in:

<60yo
If BP:
140/90mm
Hg

60yo
Target BP:
<140/90

If BP:
150/90mm
Hg

Initiate treatment in:

Nonblack population
(including those with DM)
Thiazide diuretics;
CCB;
ACEi/ARB

18yo
DM
Target BP:
<150/90

with

Target BP:
<140/90

Black population
Thiazide diuretics;
CCB

But must support initial or add-on antihypertensive therapy with an ACEi or ARB in
persons with CKD to improve kidney outcomes.

Main objective of hypertension treatment: attain and maintain goal BP.

1. If goal BP is not reached within a month of treatment of the initial drug

increase the dose of the initial drug or add a second drug from one of the
classes of Thiazide-type diuretic, CCB, ACEi, or ARB.
2. If goal BP cannot be reached with 2 drugs add and titrate a third drug from
the drug list.
DO NOT USE ACEi and ARB together in the same patient.
3. If goal BP cannot be reached using the above drugs due to contraindication or
need to use more than 3 drugs to reach goal BP antihypertensive drugs from
other classes can be used.

Reference:
JNC 8. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in
Adults.