HTN Medications

This site follows the AAFP guideline: a standard target of <140/90 mmHg for most adults. Dr. Anderson is AAFP board-certified and backs the AAFP recommendations, which weigh the benefits of BP lowering against its harms (falls, orthostasis, polypharmacy, acute kidney injury) in primary-care populations. For context, the 2025 AHA/ACC guideline reaffirms <130/80 mmHg — and encourages <120 systolic where tolerated (SPRINT) — and adopts the new PREVENT risk calculator to decide when to start drugs in stage 1 (130–139/80–89); AAFP again declined to endorse it. Both agree on key exceptions: chronic hypertension in pregnancy targets <140/90 mmHg (CHAP), and for frail patients or those with limited life expectancy a relaxed target (e.g., <150/90 mmHg) is reasonable to avoid falls and orthostatic hypotension.

Many patients require two or more medications with different mechanisms of action to achieve blood pressure control. This often allows for lower doses of each, reducing side effects.

This occurs when blood pressure readings are high in a medical setting but normal at home. Home blood pressure monitoring is essential to confirm the diagnosis and avoid overtreatment.