Table 7.
Guidelines | Initial treatment | Two-drug combinations | Three-drug combinations |
---|---|---|---|
JNC 8 | Thiazide diuretic, CCB, ACEI or ARB | Add a drug from another class: thiazide diuretic, CCB, ACEI or ARB | CCB + thiazide + ACEI or ARB |
Alone or in combination | |||
ASH/ISH | Stage 1: ACEI or ARB | CCB or thiazide + ACEI or ARB | CCB + thiazide + ACEI or ARB |
Stage 2: 2 drugs | |||
AHA/ACC/CDC | Stage 1: Thiazide for most patients or ACEI, ARB, CCB | Add a drug from another class, either, thiazide diuretic, CCB, ACEI or ARB | Not specified |
Stage 2: Thiazide + ACEI, ARB or CCB OR ACEI + CCB | |||
CHEP | Thiazide, β-blocker, ACEI, ARB, CCB | Add a drug from another class, either, thiazide, β-blocker, CCB, ACEI or ARB | Not specified |
Consider combination if SBP ≥20 mmHg or DBP ≥10 mmHg above target | |||
ESH/ESC | Stage 1: Diuretics, ACEI, ARB, CCB or β-blocker |
Preferred combinations: Thiazide + ARB or ACEI Thiazide + CCB CCB + ARB or ACEI |
Add a drug from another class: thiazide diuretic, CCB, ACEI, ARB or β-blocker |
Stage 2: 2 drugs | |||
France | Initiating treatment with ARB or ACEI (better persistence versus diuretic or β-blocker) | Add a drug from another class: thiazide, β-blocker, CCB, ACEI or ARB. | CCB + thiazide + ACEI or ARB |
CCB (for adherence) is preferred versus diuretic or β-blocker | |||
NICE | <55 years, ACEI or ARB | CCB + ACEI or ARB | CCB + thiazide + ACEI or ARB |
>55 years CCB | |||
Taiwan | Stage 1: Thiazide diuretic, CCB, ARB or ACEI | ACEI or ARB + CCB or thiazide | CCB + thiazide + ACEI or ARB |
Stage 2: 2 drugs | |||
China |
Stage 1: Thiazide diuretic, CCB, ARB, ACEI or β-blocker Stage 2: SPCs of 2 drugs |
CCB + ACEI or ARB OR ACEI or ARB + thiazide OR CCB + thiazide. OR CCB + β-blocker |
CCB + ACEI or ARB + thiazide OR CCB + ACEI or ARB + β-blocker OR ACEI or ARB + thiazide + α- blocker |
AHA/ACC/CDC American Hypertension Association/American College of Cardiology/Centers for Disease Control and Prevention, ASH/ISH American Society of Hypertension/International Society of Hypertension, CHEP Canadian hypertension education program, ESH/ESC European Society of Hypertension/European Society of Cardiology, JNC 8 Eighth Joint National Committee, NICE National Institute for Clinical Excellence (UK), ACEI angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, CCB calcium channel blocker, SPC single pill combination