In the majority of cases of hypertension, no detectable underlying disease is present. There are several theories as to why the blood pressure may be increased. This type

HYPERTENSION

TABLE 1
Classification and Management of Blood Pressure for Adults*
SBPa DBPb Lifestyle Initial drug therapy
BP


Without With compelling
Classification mmHg mmHg modification compelling indication indications
Normal <120 and <80 Encourage
Prehypertension 120–139 or 80–89 Yes No antihypertensive drug indicated. Drug(s) for compelling indications.b
Stage 1 hypertension 140–159 or 90–99 Yes Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination. Drug(s) for the compelling indications.c Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed.
Stage 2 hypertension >160 or >100 Yes Two-drug combination for mosty


(usually thiazide-type diuretic and
ACEI or ARB or BB or CCB).
DBP, diastolic blood pressure: SBP, systolic blood pressure.
Drug abbreviations: ACEI, angiotensin coverting enzyme inhibitor; ARB, angiotensin receptor blocker; BB, beta-biocker; CCB, calcium channel blocker.
aTreatment determined by highest BP category.
bInitial combined therapy should be used cautiously in those at risk for orthostatic hypotension.

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