Classification of Blood Pressure
Category SBP   DBP
Normal < 120 and < 80
Pre-hypertension 120-139 or 80-89
Stage 1 Hypertension 140-159 or 90-99
Stage 2 Hypertension > 160 or > 100
Treatment Options
1. Thiazide diuretics - first line agents in all patients with good renal function (CrCl > 30): Hydrochlorothiazide 12.5-25mg qd; In patients with impaired renal function (CrCl < 30) or congestive heart failure, use loop diuretics
2. Beta-blockers - also used as a first line agent, especially in post-MI, treatment of migrane, angina, and atrial fibrillation; do not use in 2nd or 3rd degree heart block; monior heart rate and EKG
3. ACE Inhibitors - first line agent in diabetic patients (with proteinuria); also useful in post-MI, heart failure, renal insufficiency, and hyperlipidemia.  Do not use in renal artery stenosis, and watch for hyperkalemia
4. Angiotensin Receptor Blockers - useful in diabetic patients where an ACE inhibitor cannot be tolerated or failed
5. Calcium Channel Blockers - mainly second line agent.  Useful in isolated systolic hypertension (diuretic first line), diabetes with proteinuria (ACE inhibitor first line), atrial fibrillation (only non-DHP agents), renal insufficiency, and dyslipidemia.  Do not use in heart block or congestive heart failure.  Only use norvasc/plendil in heart failure.
6. Centrally acting Alpha Receptor Agonists - not used as first line agents.  Useful in diabetic patients, renal insufficiency, and tachycardia (methyldopa, clonidine)
7. Alpha-1 Blockers - useful in BPH, but do not use as primary treatment of hypertension
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