CCB-ACE inhibitor, CCB-ARB, and CCB-thiazide diuretic are preferr

CCB-ACE inhibitor, CCB-ARB, and CCB-thiazide diuretic are preferred combinations NICE (UK) [25] CCBs are recommended as first line in patients aged ≥55 years and in Blacks of African or Caribbean origin of any age (unless compelling indications against). Other patients aged <55 years may be offered an ACE inhibitor or a low-cost ARB The combination of a CCB-ACE inhibitor or CCB-ARB are recommended as second-line treatment options

ISH-ASH (international) [4] An ACE inhibitor or ARB should be initiated as monotherapy in non-Black patients aged <60 years and a CCB or PND-1186 mw thiazide diuretic in those aged >60 years (CCB or thiazide diuretic recommended for all Black patients) Dose adjustment or a combination with another class of agent should be considered MK-8931 supplier every 2–3 weeks if response

is not seen. Combination therapy (CCB or thiazide diuretic plus ACE inhibitor or ARB) should be considered first line in patients with BP ≥20/10 mmHg above the target Interclick here National Society on Hypertension in Blacks [45] In the absence of compelling indications, when BP is near goal levels, monotherapy with a diuretic

or a CCB is preferred because of a greater likelihood of attaining goal BP with either of these agents as monotherapy in Blacks. Combination therapy should be initiated when SBP is >15 mmHg and/or DBP is >10 mmHg above goal levels. CCBs or diuretics in combination with each other or with an ACE inhibitor or ARB are recommended Canadian Hypertension Education Program [23] Thiazide diuretics, β-blockers (in patients aged <60 years), ACE inhibitors (in non-Black patients), long-acting very CCBs or ARBs are recommended as initial monotherapy. Combination of two first-line drugs may be considered as initial therapy if SBP is >20 mmHg or DBP >10 mmHg above the target. Two-drug combinations of β-blockers, ACE inhibitors, and ARBs are not recommended Joint National Committee (USA) [3] Thiazide-type diuretics, CCBs, ACE inhibitors, or ARBs are recommended as initial treatment in non-Black patients with hypertension and thiazide-type diuretics or CCBs for the general Black population. If goal BP is not reached within 1 month, up titration or combination with another class of agent should be considered.

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