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. Author manuscript; available in PMC: 2020 Dec 4.
Published in final edited form as: Circ Cardiovasc Qual Outcomes. 2019 Nov 12;12(11):e000057. doi: 10.1161/HCQ.0000000000000057

Table 3.

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

ASCVD Risk Stage 2 High BP (≥140 mmHg) 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.