HTN Recommendations

Question 1

Recommendation 1, patients over 60

Answer 1

In the general population aged over 60 years, initiate pharmacologic treatment to lower blood pressure (BP) and treat to a goal SBP <150 mm Hg and goal DBP <90 mm Hg. (Strong Recommendation – Grade A)

Question 2

Corollary Recommendation, over 60

Answer 2

In the general population aged over 60 years, if pharmacologic treatment for high BP results in lower achieved SBP (eg, <140 mm Hg) and treatment is well tolerated and without adverse effects on health or quality of life, treatment does not need to be adjusted. (Expert Opinion – Grade E)

Question 3

Recommendation 2 , under 60

Answer 3

In the general population under 60 years, initiate pharmacologic treatment and treat to a goal DBP <90mmHg. (For ages 30-59 years, Strong Recommendation – Grade A; For ages 18-29 years, Expert Opinion – Grade E)

Question 4

Recommendation 3, under 60

Answer 4

Recommendation 3
In the general population under 60 years, initiate pharmacologic treatment and treat to a goal SBP <140mmHg. (Expert Opinion – Grade E)

Question 5

Recommendation 4, over 18 with CKD

Answer 5

Recommendation 4
In the population aged over 18 years with chronic kidney disease (CKD), initiate pharmacologic treatment and treat to goal SBP <140mmHg and goal DBP <90mmHg. (Expert Opinion – Grade E)

Question 6

Recommendation 7, non-black population

Answer 6

Recommendation 6
In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor
(ACEI), or angiotensin receptor blocker (ARB). (Moderate Recommendation – Grade B)

JUST PICK ONE DRUG!!

Question 7

Recommendation 7,

black population

Answer 7

Recommendation 7

In the general black population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or CCB. (For general black population: Moderate Recommendation–Grade B; for black patients with diabetes: Weak Recommendation – Grade C)

Question 8

Recommendation 8, population over 18 with CKD

Answer 8

Recommendation 8
In the population aged over 18 years with CKD, initial (or add-on) antihypertensive treatment should include an ACEI or ARB to improve kidney outcomes. This applies to all CKD patients with hypertension regardless of race or diabetes status. (Moderate Recommendation – Grade B)

Question 9

patient over 60, goal of treatment for HTN

Answer 9

rec 1- SBP < 150; DBP < 90

Corollary to 1- if BP is lowered and the patient is doing well, tx does not need to be adjusted further.

Question 10

patients ages 30-59

Answer 10

rec 2: SBP < 140: grade A

Question 11

patient ages 18-29

Answer 11

rec 2: SBP <140, Grade E

Question 12

patients over 18 with CKD

Answer 12

SBP < 140, DBP < 90 both Grade E

Question 13

non black population, diabetics

Answer 13

rec 6- HTN tx should include a thiazide, calcium channel blocker, ACEI; OR an ARB

Question 14

black population, including diabetics

Answer 14

HTN tx shld include a thiazide type diuretic or a CCB- weak recommendation, Grade C

Question 15

over 18 with CKD, and diabetics included

Answer 15

rec 8: INITIAL HTN tx shld include ACEI or ARB to improve kidney outcomes. No race or diabetes status needed to be considered. Grade B