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Blood Pressure Management
5.2.2. Blood Pressure Treatment Threshold and the Use of
CVD Risk Estimation to Guide Drug Treatment of Hypertension
COR LOE
Recommendations
1 A
1. In all adults with hypertension, initiation of medications to
lower BP is recommended when average SBP is ≥140 mm Hg
to reduce the risk of cardiovascular events and total mortality.
1 A
2. In all adults with hypertension, initiation of medications to
lower BP is recommended when average DBP is ≥90 mm Hg
to reduce the risk of cardiovascular events and total mortality.
1 A
3. In adults with hypertension and clinical CVD, initiation of
medications to lower BP is recommended when average SBP
is ≥130 mm Hg to reduce the risk of cardiovascular events
and total mortality.
1 C-LD
4. In adults with hypertension and clinical CVD, initiation of
medications to lower BP is recommended when average DBP
is ≥80 mm Hg to reduce the risk of cardiovascular events and
total mortality.
1 A
5. In adults with hypertension without clinical CVD but with
diabetes or CKD or at increased short-term CVD risk (ie,
estimated 10-year CVD risk ≥7.5% based on PREVENT*),
initiation of medications to lower BP is recommended when
average SBP is ≥130 mm Hg to reduce the risk of CVD
events and total mortality.
1 C-LD
6. In adults with hypertension without clinical CVD but with
diabetes or CKD or at increased 10-year CVD risk (ie, ≥7.5%
based on PREVENT*), initiation of medications to lower BP
is recommended when average DBP is ≥80 mm Hg to reduce
the risk of CVD events and total mortality.
5.2. Medical Management
5.2.1. Initiation of Pharmacologic Blood Pressure Treatment
in the Context of Overall CVD Risk
