Designed and created by Guideline Central in participation with the Veterans Health Administration / Department of Defense
Diagnosis and Management of Hypertension (HTN) in Primary Care
Publication Date: April 1, 2020
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the Department of Veterans Affairs, Department of Defense, for hypertension in the primary care setting. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.
- Hypertension (high blood pressure) is a major risk factor for cardiovascular (heart and blood vessel) diseases.
- There are many causes for hypertension, but most cases do not have an identifiable cause.
- Some of the identifiable causes of hypertension are kidney- or hormone-related.
- Hypertension causes no symptoms, earning it the title “the silent killer.”
- This patient summary focuses on managing hypertension in the primary care setting.
- Everyone should have a blood pressure check regularly.
- Many measurements in both home and office are needed to characterize the type and degree of your hypertension.
- If you have elevated blood pressure, you should have a sphygmomanometer (a device that measures blood pressure) and learn how to use it.
- Once characterized, you may need additional testing to look for a cause.
- The goal of treatment is to reduce your blood pressure to 130/90, with possible adjustments for age.
- Treatment is with medications unless a cause is identified.
- There are dozens of medicines in several classes that are used to lower blood pressure. The VA recommends:
- diuretics that reduce body water through increased urination
- calcium channel blockers
- angiotensin-converting enzyme inhibitors
- angiotensin II receptor blockers
- Blood pressure control usually requires 2-3 different medications.
- In addition to medications, lifestyle changes are important:
- Weight loss for those who are overweight
- Dietary changes: a DASH (Dietary Approaches to Stop Hypertension) diet is recommended.
- Limited salt use
- Regular aerobic exercise: at least 120 minutes spread out over each week
- No smoking
- Limited alcohol
- DASH: Dietary Approaches To Stop Hypertension
- HTN: Hypertension
- VA: Veterans Administration
Tschanz CMP, Cushman WC, Harrell CTE, Berlowitz DR, Sall JL. Synopsis of the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense Clinical Practice Guideline: The Diagnosis and Management of Hypertension in the Primary Care Setting. Ann Intern Med. 2020 Dec 1;173(11):904-913. doi: 10.7326/M20-3798. Epub 2020 Sep 1. PMID: 32866417.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.