MIMS Summary Table MANAGEMENT OF HYPERTENSION BP Classification Recommended Initial Drug Thera (Syston Be rpaastalic BP | Lifestyle Modification ohne kl te ‘mm Hg) Without Compelling indications | With Compelling Indications Pre-hypertension ‘Start Mesivie moattication | No ant oe * Pationt w/ chronic kidney (120-139/80-80) ie tament |" jeoase or debotes shuld be treated to achieve BP goal of -<190/80 mm Hg ‘Stage 1 Hypertension ‘Star lifestyle modification | « Thiazide-ype diuretics eter | « Pationt w ehvoni Kidney disaase (140-158/80-28) alone or in combination or diabotes should be treated to ‘May consider ACEI, AlIA, BB, Achieve BP goal of <190/80 mn Hg CA.r combination “+ Siat drug for compelling Indication + Other anthypertensives (Giurtics, ACEI, AIA, BB, CA) 2s needed Stage 2 Hypertension Start Hestyle modification | « Two-drug combination (usually | « Patient w! chronic kidney dssace (160100) thiazde-ype diuretic and ACEI, | or diabetes should be trated to orAllA, or BB, or CA) ‘achieve BP goal of <130/80 mm Hg 1 Use cautiously in patients at + Start drug for competing indiation Fisk for orthostatic hypertension |» Other anthyperiensves (crt, ACE! AllA, BB, CA) as needed AAIIA= Angiotensin Il antagonists BB = Beta-biockers CA-= Calcium antagonists Recommended Antihypertensives Competing Indication ACE Angiotensin Il Beta- Calcium - Inhibitors | Antagonists | Blockers | Antagonists | Loop | Thiazide Diuretics Anti Aldosterone) MIMS Class 20 2 2 28 2h Cerebrovascular v Disease (combined wi diuretics) CHF “Asymptomatic patients w/ ’ ¥ ventricular dysfunction CHE ‘Symptomatic patients w/ ventricular “ ¥ * iA ¥ ‘ystunction or | ‘end-stage: | heart disease t Diabetes Melitus v v v v “ ¥ Loft Venticular Dysfunction ¥ ‘Non-Diabetic Nephropathy v Poot MI ¥ ieee Type 1 Diabetic Nephropathy v ‘Type 2 Diabetic Nephropathy v ¥ Refer to Summary Tables in respective MIMS sections for further information on modes of action and recommended dosage rogimens. ‘Some Recommended Antihypertensive Combinations + Diuretic + (ACE inhibitor, angiotensin Il antagonist, beta-blocker or calcium antagonist) + Angiotensin I antagonist + caleium antagonist * ACE inhibitor + (alpha-blocker or calcium antagonist) + Beta-blocker + (alpha-blocker or calcium antagonist) Many antihypertensive fixed-dose combinations are available, prescribing information. lease see latest MIMS & MIMS Annual for specific formulations & Please refer to the Contents page for more Summary Tables. ‘wertqnenoos Dey