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Template:Initial Outpatient Hypertension Medications
From WikEM
Initial outpatient hypertension medications
- First line for people without comorbidities
- Hydrochlorothiazide 12.5mg, max 25mg
- Need labs before starting, does not work in people with CKD
- Hydrochlorothiazide 12.5mg, max 25mg
- First line for people with DM and/or proteinuria
- ACEi/ARB: Lisinopril either Qday or BID
- Need Chem 10 before and after starting to check for hyperkalemia and creatinine
- Start 10mg lisinopril QD
- ACEi/ARB: Lisinopril either Qday or BID
- Anyone with CAD, CHF
- Beta-Blocker (do not need labs)
- Amlodipine for anyone, except for people with LE edema (do not need labs)
- Start amlodipine 5mg QD
- Diltiazem for proteinuria in people unable to tolerate ACEi (do not need labs)
- Lasix for CHF and/or lower extremity edema secondary to proteinuria
JNC 8 Recommendations[1]
| Population | Non-black Patients | Black Patients |
|---|---|---|
| General population | thiazide, CCB, ACEI, or ARB | thiazide or CCB |
| CKD | ACEI or ARB | ACEI or ARB |
| DM | thiazide, CCB, ACEI, or ARB | thiazide or CCB |
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