35
5.2.2. Blood Pressure Treatment Threshold and the Use of
CVD Risk Estimation to Guide Drug Treatment of Hypertension
(cont'd)
COR LOE
Recommendations
1 B-R
7. In adults with hypertension without clinical CVD and with
estimated 10-year CVD risk <7.5% based on PREVENT*,
initiation of medications to lower BP is recommended if
average SBP remains ≥130 mm Hg after a 3- to 6-month trial
of lifestyle intervention to prevent target organ damage and
mitigate further rise in BP.
1 B-R
8. In adults with hypertension without clinical CVD and with
estimated 10-year CVD risk <7.5% based on PREVENT*,
initiation of medications to lower BP is recommended if
average DBP ≥80 mm Hg after a 3- to 6-month trial of
lifestyle intervention to prevent target organ damage and
mitigate further rise in BP.
* Increased short-term or 10-year risk is defined as a 10-year predicted risk for CVD events of
≥7.5% based on PREVENT (Predicting Risk of cardiovascular disease EVENTs).
5.2.3. Initial Medication Selection for Treatment of Primary
Hypertension
COR LOE
Recommendation
1 A
1. For adults initiating antihypertensive drug therapy, thiazide-
type diuretics, long-acting dihydropyridine CCB, and ACEi or
ARB are recommended as first-line therapy to prevent CVD.
