Template:Initial Outpatient Hypertension Medications

Initial Outpatient Hypertension Medications

• First line for people without comorbidities
  • Hydrochlorothiazide 12.5mg, max 25mg
    • Need labs before starting, does not work in people with CKD
• First line for people with DM and/or proteinuria
  • ACEi/ARB: Lisinopril either Qday or BID
    • Need Chem 10 before and after starting to check for hyperkalemia and creatinine
    • Start 10mg lisinopril QD
• Anyone with CAD, CHF
  • Beta-Blocker (do not need labs)
• Amlodipine for anyone, except for people with LE edema (do not need labs)
  • Start amlodipine 5mg QD
• Diltiazem for proteinuria in people unable to tolerate ACEi (do not need labs)
• Lasix for CHF and/or lower extremity edema secondary to proteinuria

JNC 8 Recommendations

Population	Non-black Patients	Black Patients
General population	thiazide, CCB, ACEI, or ARB	thiazide or CCB
CKD	ACEI or ARB	ACEI or ARB
DM	thiazide, CCB, ACEI, or ARB	thiazide or CCB