Antihypertensive types

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
  • 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[1]

PopulationNon-black PatientsBlack Patients
General populationthiazide, CCB, ACEI, or ARBthiazide or CCB
DMthiazide, CCB, ACEI, or ARBthiazide or CCB

See Also


  1. James PA, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5):507-520.
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