Algorithm for Treatment of Hypertension
Not at Goal Blood Pressure
(<140/90 mmHg)
(<130/80 mmHg for those with diabetes or chronic kidney disease)
(<130/80 mmHg for those with diabetes or chronic kidney disease)
Initial Drug Choices
Drug(s) for the
compelling indications
Other antihypertensive
drugs (diuretics,
ACEI, ARB, BB, CCB)
as needed.
as needed.
With Compelling
Indications
Indications
Lifestyle Modifications
Stage 2 Hypertension
(SBP >160 or DBP >100 mmHg)
2-drug combination for most (usually thiazide-type diuretic and
ACEI, or ARB, or BB, or CCB)
(SBP >160 or DBP >100 mmHg)
2-drug combination for most (usually thiazide-type diuretic and
ACEI, or ARB, or BB, or CCB)
Stage 1 Hypertension
(SBP 140–159 or DBP 90–99 mmHg)
Thiazide-type diuretics for most.
May consider ACEI, ARB, BB, CCB,
or combination.
(SBP 140–159 or DBP 90–99 mmHg)
Thiazide-type diuretics for most.
May consider ACEI, ARB, BB, CCB,
or combination.
Without Compelling
Indications
Indications
Not at Goal
Blood Pressure
Blood Pressure
Optimize dosages or add additional drugs
until goal blood pressure is achieved.
Consider consultation with hypertension specialist.
until goal blood pressure is achieved.
Consider consultation with hypertension specialist.
