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4.2.7. Blood Pressure Management
COR LOE
Recommendations
1 A 1. In adults with CCD, nonpharmacologic strategies are
recommended as first-line therapy to lower BP in those with
elevated BP (120–129/<80 mm Hg ) (see Table 12).*
1 B-R 2. In adults with CCD who have hypertension, a BP target of
<130/<80 mm Hg is recommended to reduce CVD events
and all-cause death.*
1 B-R 3. In adults with CCD and hypertension (systolic BP
≥130 and/or diastolic BP ≥80 mm Hg ), in addition to
nonpharmacological strategies, GDMT angiotensin-
converting enzyme (ACE) inhibitors, angiotensin-receptor
blockers (ARB), or beta blockers are recommended as
first-line therapy for compelling indications (eg, recent MI
or angina), with additional antihypertensive medications (eg,
dihydropyridine calcium channel blockers [CCB], long-
acting thiazide diuretics, and/or mineralocorticoid receptor
antagonists) added as needed to optimize BP control.*
* Modified from the 2017 ACC/AHA/Multisociety guideline for the prevention, detection,
evaluation, and management of high blood pressure in adults. Whelton PK, et al. J Am Coll
Cardiol. 2018;71:e127-e248.
Table 12. Nonpharmacologic Strategies for Blood Pressure
Management*
Nonpharmacologic
Intervention Dose
Approximate Impact
on SBP
Hypertension Normotension
Weight loss Weight/body
fat
Best goal is ideal body
weight but aim for at least
a 1 kg reduction in body
weight for most adults who
are overweight. Expect about
1 mm Hg for every 1 kg
reduction in body weight.
- 5 mm
Hg
- 2–3 mm
Hg
Healthy diet DASH dietary
pattern
Consume a diet rich in
fruits, vegetables, whole
grains, and low-fat dairy
products, with reduced
content of saturated and
total fat.
- 11 mm
Hg
- 3 mm
Hg
