Table 10.

Recommendations for pharmacological management of hypertension. ACEi: Angiotensin-converting enzyme inhibitor; ARB: Angiotensinreceptor blocker; BP: blood pressure; CCB: calcium channel blocker; RAS: renin angiotensin system; SBP: systolic blood pressure.

Class	Recommendation
	The main target of treatment is to control BP.
	Antihypertensive medications that can be considered for initial treatment: Diuretics (thiazide and thiazide-like agents) ACEis ARBs Long-acting dihydropyridine CCBs Beta blockers (when indicated)
	Beta blockers can be used in specific indications (young age, sympathetic overdrive, ischemic disease, heart failure, obesity/bariatric surgery).
	Single-pill combination treatment is recommended as initial therapy for all people with hypertension with the exception of elderly, frail or younger people with low risk. The combination of a RAS blocker with a CCB or a diuretic is preferred.
	Monotherapy can be considered for: People at low-risk with stage 1 hypertension with SBP <150 mmHg People at very high-risk with elevated BP frail older people.
	If BP control is not achieved with a two-drug combination, three-drug regimens (including a RAS blocker, a CCB, and a diuretic) should be considered.
	In exceptional cases where BP remains uncontrolled with all recommended drug classes, other classes of antihypertensive drugs should be considered, such as spironolactone (or other diuretics if spironolactone not tolerated), a beta blocker, an alpha blocker or direct vasodilators.