Classification of Blood Pressure |
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Category |
Systolic (mm Hg) |
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Diastolic (mm
Hg) |
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Normal |
< 120 |
and |
< 80 |
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Prehypertension |
120-139 |
or |
80-89 |
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Stage I Hypertension |
140-159 |
or |
90-99 |
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Stage II Hypertension |
> 160 |
or |
> 100 |
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Management of
Blood Pressure |
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Initial
Therapy |
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BP Classification |
Lifestyle Modification |
w/o compelling indication |
w/ compelling
indication |
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Normal |
Encourage |
None |
None |
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Prehypertensive |
Yes |
None |
Treat patients with chronic kidney
disease or diabetes to BP goal of < 130/80 |
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Stage I Hypertension |
Yes |
Thiazide-type diuretic for most; consider ACEI, ARB, B-blocker,
CCB, or combination |
Drugs for the compelling
indications; other antihypertensives as needed |
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Stage II Hypertension |
Yes |
Two drug combos (typically thiazide-type diuretic and ACEI, ARB,
B-blocker, or CCB). Use combo with
caution in patients at risk for orthostasis |
Drugs for the compelling indications; other antihypertensives as
needed |
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Compelling
Indications |
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Chronic Kidney
Disease |
Diabetes Mellitus |
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1. ACE
Inhibitiors |
1. ACE Inhibitiors |
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2. Angiotensin
Receptor Blockers (ARB's) |
2. Angiotensin Receptor Blockers (ARB's) |
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3. Beta-blocking agents |
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Heart Failure |
4. Calcium channel blockers |
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1. ACE
Inhibitiors |
5. Diuretics |
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2. Aldosterone
blocking agent |
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3. Angiotensin
Receptor Blockers (ARB's) |
High Coronary Risk |
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4.
Beta-blocking agents |
1. ACE Inhibitiors |
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5. Diuretics |
2. Beta-blocking agents |
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3. Calcium channel blockers |
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Myocardial
Infarction |
4. Diuretics |
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1. ACE
Inhibitiors |
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2. Aldosterone
blocking agent |
Recurrent Stroke Prevention |
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3.
Beta-blocking agents |
1. ACE Inhibitiors |
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2. Diuretic |
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Return
to Main Index |
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