Recommendations for Adults With High Blood Pressure or Hypertension.

Referenced studies that support recommendations are summarized in Online Data Supplements 13 and 14.

COR	LOE	Recommendations
I	A	1. In adults with elevated blood pressure (BP) or hypertension, including those requiring antihypertensive medications nonpharmacological interventions are recommended to reduce BP. These include:  weight lossS4.4-2–S4.4-5;  a heart-healthy dietary patternS4.4-6–S4.4-8;  sodium reductionS4.4-9–S4.4-13;  dietary potassium supplementationS4.4-14–S4.4-18;  increased physical activity with a structured exercise programS4.4-3,S4.4-5,S4.4-11,S4.4-19–S4.4-23; and  limited alcohol.S4.4-24–S4.4-29 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
I	SBP:A	2. In adults with an estimated 10-year ASCVD risk* of 10% or higher and an average systolic BP (SBP) of 130 mm Hg or higher or an average diastolic BP (DBP) of 80 mm Hg or higher, use of BP-lowering medications is recommended for primary prevention of CVD.S4.4-30–S4.4-38 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
	DBP:C-EO
I	SBP:B-RSR	3. In adults with confirmed hypertension and a 10-year ASCVD event risk of 10% or higher, a BP target of less than 130/80 mm Hg is recommended.S4.4-33,S4.4-39–S4.4-42 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
	DBP:C-EO
I	SBP:B-RSR	4. In adults with hypertension and chronic kidney disease, treatment to a BP goal of less than 130/80 mm Hg is recommended.S4.4-43–S4.4-48 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
	DBP:C-EO
I	SBP:B-RSR	5. In adults with T2DM and hypertension, antihypertensive drug treatment should be initiated at a BP of 130/80 mm Hg or higher, with a treatment goal of less than 130/80 mm Hg.S4.4-33,S4.4-47,S4.4-49–S4.4-54 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
	DBP:C-EO
I	C-LD	6. In adults with an estimated 10-year ASCVD risk <10% and an SBP of 140 mm Hg or higher or a DBP of 90 mm Hg or higher, initiation and use of BP-lowering medication are recommended.S4.4-36,S4.4-55–S4.4-58 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
IIb	SBP:B-NR	7. In adults with confirmed hypertension without additional markers of increased ASCVD risk, a BP target of less than 130/80 mm Hg may be reasonable.S4.4-59–S4.4-62 Adapted from recommendations in the 2017 Hypertension Clinical Practice Guidelines.S4.4-1
	DBP:C-EO

^*ACC/AHA pooled cohort equations to estimate 10-year risk of ASCVD.