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p503 PDF
October
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from the www.aafp.org/afp
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Practice Guidelines
second medication should be added (thia- initial or add-on therapy, based on moder-
zide diuretic, calcium channel blocker, ACE ate evidence that these medications improve
inhibitor, or ARB; do not combine an ACE kidney-related outcomes in these patients.
inhibitor with an ARB). Blood pressure
Guideline source: Eighth Joint National Committee
should be monitored and the treatment regi-
men adjusted until the target blood pressure Evidence rating system used? Yes
is reached. A third drug should be added if Literature search described? Yes
necessary; however, if the target blood pres-
Guideline developed by participants without rel-
sure cannot be achieved using only the drug
evant financial ties to industry? No
classes listed above, antihypertensive drugs
from other classes can be used (e.g., beta Published source: Journal of the American Medical
Association, December 18, 2013
blockers, aldosterone antagonists). Refer-
ral to a physician with expertise in treating Available at: http://jama.jamanetwork.com/article.aspx?
hypertension may be necessary for patients articleid=1791497
who do not reach the target blood pressure Endorsed by the AAFP, July 2014: http://www.aafp.org/
using these strategies. patient-care/clinical-recommendations/all/highbloodpres-
Adults with CKD and hypertension sure.html
should receive an ACE inhibitor or ARB as CARRIE ARMSTRONG, AFP Senior Associate Editor ■
Let the AAFP help you master the business side of your practice, so you can
get back to your real job: Providing quality care to your patients.