Initiate drug tx if SBP ≥140 or DBP ≥90 [E]; goal is <140/90 [E]

By vgreene, 20 May, 2015
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<sup>5</sup> All 4 drug classes yield comparable effects on overall mortality & CV/cerebrovasc/kidney outcomes; however, for HF outcomes, initial thiazide tx more effective than CCB or ACEI, and ACEI more effective than CCB.<br><br><sup>6</sup> If goal BP cannot be reached, drugs from non-recommended classes may be used; consultation w/ a HTN specialist may be indicated [E].
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Nonblack pts initial tx: thiazide diuretic, CCB, ACEI, or ARB [B]<sup>5</sup> + lifestyle
Black pts initial tx: thiazide diuretic or CCB [C] + lifestyle
At 1 mo: If not at goal, increase dose or add 2nd drug; do not combine ACEI + ARB. Reassess, add/titrate 3rd drug if needed.<sup>6</sup>