Classification and management of BP for adults Category Systolic Diastolic Lifestyle Initial drug modification therapy Normal <120 and <80 Encourage Not needed No,or treat Pre-hypertension 120-139 or 80-89 Yes Compelling indications Stage 1 hypertension 140-1590r 90-99 Yes Diuretic,ACEl,ARB.B-blocker.CCB. Combination;+compelling indications Stage 2 hypertension ≥160 or 2100 Yes Two-drug combo (diuretic and ACEl. or ARB or B-blocker or CCB: Also treat compelling indications Based on 7th Report of the Joint National Committee on Detection,Evaluation,and Treatment of High BP(JNC 7) Diuretic here means thiazide-type;ACEl,ACE inhibitor;ARB,angiotensin receptor blocker;B-blocker,B-adrenergic receptor blocker,CCB,calcium channel blocker Hypertension is a leading global risk factor for mortality 8000- 7000 High-mortality,developing region Lower-mortality.developing region 6000- ▣Developed region 5000 4000 3000 2000 1000 0- LO* The Lancet,360:1347(2002) 22 Normal Pre-hypertension Stage 1 hypertension Stage 2 hypertension Category Systolic Diastolic < 120 120-139 140-159 ≥ 160 and or or or < 80 80-89 90-99 ≥ 100 Classification and management of BP for adults Based on 7th Report of the Joint National Committee on Detection, Evaluation, and Treatment of High BP (JNC 7) Lifestyle modification Encourage Yes Yes Yes Initial drug therapy Not needed No, or treat Compelling indications Diuretic, ACEI, ARB, β-blocker, CCB, Combination; + compelling indications Two-drug combo (diuretic and ACEI, or ARB or β-blocker or CCB; Also treat compelling indications Diuretic here means thiazide-type; ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; β-blocker, β-adrenergic receptor blocker; CCB, calcium channel blocker Hypertension is a leading global risk factor for mortality The Lancet, 360:1347 (2002)