3
7. In adults with average blood pressure ≥130/80 mm Hg and at
lower 10-year cardiovascular disease risk defined by PREVENT of
<7.5%, initiation of medication therapy to lower blood pressure is
recommended if average blood pressure remains ≥130/80 mm Hg
after an initial 3- to 6-month trial of lifestyle modification.
8. For all adults with stage 2 hypertension, the initiation of
antihypertensive drug therapy with 2 first-line agents of different
classes in a single-pill, fixed-dose combination is preferred over
2 separate pills to improve adherence and reduce time to achieve
blood pressure control.
9. Home blood pressure monitoring combined with frequent
interactions with multidisciplinary team members using
standardized measurement and treatment protocols is an important
integrated tool to improve rates of blood pressure control. Reliance
on cuffless devices, including smartwatches, for accurate blood
pressure measurements should be avoided until these devices
demonstrate greater precision and reliability.
10. Severe hypertension in nonpregnant individuals, defined as blood
pressure >180/120 mm Hg, without evidence of acute target
organ damage, should be evaluated and treated in the outpatient
setting with initiation, reinstitution, or intensification of oral
antihypertensive medications in a timely manner.
