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(Hypertension 2003;42:1206)
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- 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
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- 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)
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- Certain combination therapies have synergistic effects &/or are proven regimens
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