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Consider Meds for Persistent Stage 1 HTN at Six Months

THURSDAY, April 29, 2021 -- Consideration should be given to the addition of medications for adults with stage 1 hypertension not meeting blood pressure goals after six months of lifestyle therapy, according to a scientific statement issued by the American Heart Association and published online April 29 in Hypertension.

Daniel W. Jones, M.D., from the University of Mississippi Medical Center in Jackson, and colleagues provided information complementary to the 2017 Hypertension Clinical Practice Guidelines for patients with untreated stage 1 hypertension with a 10-year risk for atherosclerotic cardiovascular disease <10 percent who failed to meet the blood pressure goal of <130/80 mm Hg after six months of guideline-recommended lifestyle therapy.

The authors note that for patients with stage 1 hypertension not achieving target blood pressure within six months, lifestyle therapy should be continued and the addition of medication from one of the four classes recommended in the 2017 guideline should be considered. Patients identified as having hypertension during childhood or adolescence who were prescribed antihypertensive drug therapy should have the original indications considered as well as the need to continue medication and lifestyle therapy as young adults. Special consideration should be given to antihypertensive medication use for those with a family history of premature cardiovascular disease, a history of hypertension during pregnancy, or a personal history of premature birth.

"If after six months with lifestyle changes, blood measure does not improve, clinicians should consider adding medications to control blood pressure," Jones said in a statement. "That's an important message for patients to hear as well because they should check their blood pressure regularly to monitor progress."

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