Table 1.

Summary of evidence-based clinical practice guideline for initial therapy and treatment intensification for the Kaiser Permanente Northern California Hypertension Program, by year.

Year	2001	2003	2005	2007	2009
Step 1	TD or BB	TD	TD or TD + ACEI	TD or TD + ACEI	TD or TD + ACEI
Step 2	TD + BB	TD + ACEI or TD + BB	TD + ACEI	TD + ACEI	TD + ACEI
Step 3	TD + BB + ACEI	TD + BB + ACEI	TD + BB + ACEI	TD + BB + ACEI	TD + ACE + DCCB
Step 4	TD + BB + ACEI + DCCB	TD + BB + ACEI + DCCB	TD + BB + ACEI + DCCB	TD + BB + ACEI + DCCB	TD + ACE + DCCB + BB or Spironolactone

TD = thiazide diuretic; BB = beta-blocker; ACEI = angiotensin-converting enzyme Inhibitor; and DCCB=dihydropyridine calcium channel blocker