Cardiovascular Pharmacotherapy

Stage 1 = systolic 130-139 mmHg or diastolic 80-89 mmHg; stage 2 = >=140/90; normal <120/80.

<130/80 mmHg for most adults, including those with diabetes, CKD, or high ASCVD risk; individualize in frail elderly.

Thiazide/thiazide-like diuretic, ACE inhibitor or ARB, and dihydropyridine CCB; choose based on comorbidities.

Thiazide-type diuretic and/or a CCB (better BP-lowering response than ACEi/ARB monotherapy in this group).

Labetalol, nifedipine (extended-release), and methyldopa; ACEi/ARB/ARNI and direct renin inhibitors are contraindicated.

Inhibit the Na-Cl cotransporter (NCC) in the distal convoluted tubule, increasing sodium/water excretion and lowering BP.