AHA High Blood Pressure Toolkit-Pharmacists

11 TREATMENTS Antihypertensive Medication The BP threshold for antihypertensive medication should be determined based on the average BP levels and CVD risk. BP Threshold (mm Hg) Patient Scenario ≥130/80 ASCVD risk of 10% or higher OR Clinical CVD ≥140/90 ASCVD risk less than 10% Several different BP thresholds and goals for the long-term treatment of hypertension with pharmacological therapy are recommended in the guideline. Use this quick reference for a summary. Initiation of antihypertensive drug therapy with a single antihypertensive drug is reasonable in adults with stage 1 hypertension and BP goal <130/80 mm Hg with dosage titration and sequential addition of other agents to achieve the BP target. (COR IIa, LOE C-EO) Guideline-recommended treatment includes nonpharmacologic interventions for patients with elevated BP or stage 1 hypertension and an estimated 10-year CVD risk of less than 10%. A combination of antihypertensive medication and nonpharmacologic interventions is recommended for patients with stage 1 hypertension and an estimated 10-year ASCVD risk of 10% or higher and for all patients with stage 2 hypertension. Nonpharmacologic Interventions The guideline recommends several nonpharmacologic interventions that have been shown to reduce systolic BP by as much as 11 mm Hg in adults with hypertension. These interventions also can help prevent hypertension in adults with normal BP. • Weight loss for patients who are overweight or obese • Heart-healthy diet (such as DASH) • Sodium reduction • Potassium supplementation (preferably in dietary modification) • Increased physical activity with structured exercise program • Limitation of alcohol to one (women) or two (men) standard drinks per day* *In the United States, one “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 ounces of regular beer (usually about 5% alcohol), 5 ounces of wine (usually about 12% alcohol) and 1.5 ounces of distilled spirits (usually about 40% alcohol). Nonpharmacological Interventions Dispensing Advice Talk to your patients about the benefits of lifestyle changes in reducing BP. Give them the “What Can I Do To Improve My Blood Pressure” r esource as a reminder for them at home. Pharmacological Interventions