Initiate drug tx if SBP ≥150⁷ or DBP ≥90 [A]; goal is <150/90⁷ [A]; no need to adjust existing tx if SBP <140 and tx is well tolerated [E]

⁷ Some panel members recommend retaining SBP goal of <140 in pts ≥60 yo, esp in high-risk groups like black persons, CVD (incl. stroke), and multiple risk factors [E].<br><br> ⁸ 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>
⁹ If goal BP cannot be reached, drugs from non-recommended classes may be used; consultation w/ a hypertension specialist may be indicated [E].