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(Hypertension 2003;42:1206)

  • Hypertension (HTN) staged by systolic & diastolic BP (Stages 1 & 2 HTN necessitate drug therapy)
  • Baseline evaluation: detailed medication history (including side effects & compliance) with current & previous regimens; identify coronary heart disease (CHD), risk factors & comorbidities with compelling indications
  • Identify ECG conduction abnormalities, left ventricular hypertrophy (LVH), ischemia, infarction
  • Pertinent labs: BUN, SCr, K, glucose, urinary albumin/creatinine ratio

Table 3-1 Secondary Causes of Hypertension

  • Initiate therapy based on CV risk
  • Chlorthalidone: preferred thiazide-type diuretic (J Am Coll Cardiol 2011;57:590)
  • β-Blockers: monotherapy not indicated for HTN (Cochrane Reviews 2007;1:CD002003)
  • Target BP for most patients is <140/90mmHg (Cochrane Reviews 2009;3:CD004349)
    • Aggressive BP ↓ (<130/80mmHg) associated with ↑ rate of cardiac events, especially in patients with DM (N Engl J Med 2010;362:1575)

Table 3-2 Hypertension Treatment Approach
Table 3-3 Compelling Indications & Recommended Therapy

Combination Therapy

  • Certain combination therapies have synergistic effects &/or are proven regimens

Table 3-4 Recommended Combination Therapy

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