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Choice of Initial Medication
COR LOE
Recommendations
I
A
SR
For initiation of antihypertensive drug therapy, first-line agents
include thiazide diuretics, calcium channel blockers (CCBs), and
angiotensin-converting enzyme (ACE) inhibitors or angiotensin
receptor blockers (ARBs).
Choice of Initial Monotherapy Versus Initial Combination Drug erapy
I C-EO Initiation of antihypertensive drug therapy with 2 first-line
agents of different classes, either as separate agents or in a
fixed-dose combination, is recommended in adults with stage 2
hypertension and an average BP more than 20/10 mm Hg above
their BP target.
IIa C-EO Initiation of antihypertensive drug therapy with a single
antihypertensive drug is reasonable in adults with stage 1
hypertension and BP goal <130/80 mm Hg with dosage titration
and sequential addition of other agents to achieve the BP target.
Follow-Up After Initiating Antihypertensive Drug Therapy
COR LOE
Recommendation
I B-R Adults initiating a new or adjusted drug regimen for hypertension
should have a follow-up evaluation of adherence and response to
treatment at monthly intervals until control is achieved.
Monitoring Strategies to Improve Control of BP in Patients
on Drug Therapy for High BP
COR LOE
Recommendation
I A Follow-up and monitoring aer initiation of drug therapy for
hypertension control should include systematic strategies to
help improve BP, including use of HBPM, team-based care, and
telehealth strategies.
General Principle of Drug Therapy
COR LOE
Recommendation
III:
Harm
A Simultaneous use of an ACE inhibitor, ARB, and/or renin
inhibitor is potentially harmful and is NOT recommended to
treat adults with hypertension.
