Recommend lifestyle modification, including weight loss and sodium restriction, to all patients with hypertension and as the sole initial therapy in patients with stage 1 hypertension and no target end-organ damage.
Treat patients with uncomplicated hypertension initially with a diuretic, calcium-channel blocker, or ACE inhibitor.
Consider initiating therapy with a combination of antihypertensive medications, generally including diuretics, ACE inhibitors, and/or calcium-channel blockers in untreated patients presenting with stage 2 hypertension.
Individualize antihypertensive therapy for patients with specific comorbid conditions such as diabetes, heart failure, history of MI, and chronic kidney disease.
Target a goal BP of <140/90 mm Hg in most patients.
Use a parenteral agent in a monitored setting when the DBP is markedly elevated (>140 mm Hg) and there is evidence of progressive target organ damage.
Distinguish a pseudocrisis of hypertension from a true hypertensive emergency and treat with rapid-onset medications such as labetolol, captopril, nicardipine, or clonidine.