CLINICAL MANAGEMENT GUIDELINE

Essential hypertension

ICD10: Essential (primary) hypertension [I10]

Treatment: Control Blood Pressure

NOTE: This plan is constructed regardless to other comorbidities.

The Eighth Joint National Committee (JNC 8) guideline recommends a blood pressure goal < 140/90 for 18-59 years old patients and <150/90 for >60 years old patients.


The main goal of treatment is to decrease the risk of mortality and of cardiovascular and renal morbidity.

This regimen is disregarding other morbidities.

Blood pressure categories are: elevated (120-129/<80 mmHg); stage 1 hypertension (130-139/80-89 mmHg); and stage 2 hypertension (≥140/90 mmHg). 1

NOTE: LEVEL 1 is monotherapy regimen. NOTE: LEVEL 2 a combined dual therapy. (on progress..)

Treatments

Level 1 / 2
pharmacological
Hydrochlorothiazide
ROUTE
Oral
DOSE
25.000 mg
FREQUENCY
OD
pharmacological
Chlorthalidone
ROUTE
Oral
DOSE
12.500 mg
FREQUENCY
OD
pharmacological
Amlodipine
ROUTE
Oral
DOSE
2.500 mg
FREQUENCY
OD
pharmacological
candesartan
ROUTE
Oral
DOSE
4.000 mg
FREQUENCY
OD
pharmacological
Lisinopril
ROUTE
Oral
DOSE
10.000 mg
FREQUENCY
OD
pharmacological
Diltiazem
ROUTE
Oral
DOSE
120.000 mg
FREQUENCY
OD
prevention
Hypertension education
prevention
Aerobic exercises
prevention
Weight reduction regimen
prevention
Alcohol reduction program
prevention
Low salt diet - prophylaxis

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  • Duplicating mechanism of action of effect
  • Weight based dosing
  • Contraindication
  • Renal dosing
  • Interactions to drugs or diseases
  • Hepatic dosing

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