Update on management of HYPERTENSION BMH-GT 12/03/08. Panelists : All Internists and medical staff members are welcome to participate in discussion . Hypertension: A Significant CV and Renal Disease Risk Factor. CAD. CHF LVH. Stroke. Hypertension. Renal disease. Morbidity
Panelists : All Internists and medical staff members are welcome to participate in discussion
Peripheral vascular disease
National High Blood Pressure Education Program Working Group. Arch Intern Med. 1993;153:186-208.
Without Compelling Indications
With Compelling Indications
Drug(s) for the compelling indications
Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed.
Stage 1 Hypertension(SBP 140–159 or DBP 90–99 mmHg) Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination.
Stage 2 Hypertension(SBP >160 or DBP >100 mmHg) 2-drug combination for most (usually thiazide-type diuretic and ACEI, or ARB, or BB, or CCB)
Not at Goal Blood Pressure
Optimize dosages or add additional drugs until goal blood pressure is achieved.Consider consultation with hypertension specialist.
Not at Goal Blood Pressure (<140/90 mmHg) (<130/80 mmHg for those with diabetes or chronic kidney disease)
Initial Drug Choices
Limit alcohol intake
Increase aerobic physical activity
Reduce sodium intake
Maintain adequate intake of potassium
Maintain adequate intake of calcium and magnesium
Reduce dietary saturated fat and cholesterolLifestyle Modifications
For Prevention and Management
For Overall and Cardiovascular Health