Table 1C. “Not to do” messages from the 2022 TSOC/THS Hypertension Guidelines.

• Routine office BP should not be used for the diagnosis and management of hypertension unless the recommended BP measurement protocol is followed.

• People without a habit of alcohol consumption should not start drinking for any reason.

• Binge drinking (defined as ≥ 5 and ≥ 4 drinks for men and women, respectively, in 2 hours) should be strictly prohibited to reduce BP, as well as the risk of atrial fibrillation, stroke and sudden death.

• High-intensity exercise is not recommended for patients with uncontrolled hypertension (SBP > 160 mmHg).

• Any combination of direct renin inhibitor, ACE inhibitors and ARBs is contraindicated.

• It is not recommended to lower BP in the prehospital setting without knowing the phenotypes of stroke.

• Routine aggressive BP lowering is not recommended unless BP ≥ 220/120 or in the presence of other situations needing immediate BP lowering (such as acute aortic dissection, congestive heart failure with lung edema, hypertensive encephalopathy) within 24 hours of acute ischemic stroke without undergoing thrombolytic or endovascular therapy.

• Salt reduction (less than 6 g/day) is not recommended as a non-drug therapy for gestational hypertension.

• ACE inhibitors, ARBs, DRI, ARNI, mineralocorticoid receptor antagonists, and chlorothiazide are teratogenic. Women with hypertension who become pregnant, are planning to become pregnant, or with child-bearing potential without reliable contraception, should avoid, or immediately withdraw these drugs in case of pregnancy.

• Oral contraceptives should not be used in women with uncontrolled hypertension.

• Hormone replacement therapy, as well as selective estrogen receptor modulators, should not be used for the primary or secondary prevention of CV diseases in postmenopausal women.

ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor neprilysin inhibitor; BP, blood pressure; CV, cardiovascular; DRI, direct renin inhibitor; SBP, systolic blood pressure; THS, Taiwan Hypertension Society; TSOC, Taiwan Society of Cardiology.