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. Author manuscript; available in PMC: 2020 Nov 18.
Published in final edited form as: J Am Coll Cardiol. 2019 Nov 26;74(21):2661–2706. doi: 10.1016/j.jacc.2019.10.001

TABLE 3.

Guideline Recommendation for BP-Lowering Medications: ACC/AHA COR/LOE

ASCVD Risk Stage 2 High BP (≥140 mm Hg) Stage 1 High BP (139-130 mm Hg) Elevated BP (129-120 mm Hg)
ASCVD Risk ≥10% COR: 1, LOE: A COR: 1, LOE: A Not recommended
ASCVD Risk <10% COR: 1, LOE: C-LD Not recommended Not recommended

All require intensive lifestyle modification (COR: 1, LOE: A) (applies to the entire table). For older adults (≥65 years of age) with hypertension and a high burden of comorbidity and limited life expectancy, clinical judgment, patient preference, and a team-based approach to assess risk/benefit are reasonable for decisions about intensity of BP lowering and choice of antihypertensive drugs (COR: 2a, LOE: C-EO).

ACC indicates American College of Cardiology; AHA, American Heart Association; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; COR, Class of Recommendation; and LOE, Level of Evidence.