• Follow guideline for number that is most out of range
Blood pressure reading (mmHg) Follow-up
< 120 / 80 Recheck in 2 years
120 - 139 / 80 - 89 Recheck in 1 year
140 - 159 / 90 - 99 Recheck within 2 months
160 - 179 / 100 - 110 Recheck within 1 month
≥ 180 / ≥ 110 Treat now or recheck within 1 week











Arm circumference (cm) Cuff size
22 - 26 Small adult
(size 12X22 cm)
27 - 34 Standard adult
(size 16X30 cm)
35 - 44 Large adult
(size 16X36 cm)
45 - 52 Adult thigh cuff
(size 16X42 cm)










































Lifestyle change Goal Approximate SBP reduction
Weight loss Maintain BMI 18 - 25 5 - 20 mmHg depending on starting weight
Adopt DASH diet Consume diet rich in fruits, vegetables, and low-fat dairy products 8 - 14 mmHg
Decrease sodium
(see sodium below)
Decrease daily sodium intake to ≤ 2400 mg 2 - 8 mmHg
Increase exercise At least 30 minutes a day, 5 days a week 4 - 9 mmHg
Moderate alcohol consumption No more than 2 drinks a day for males, and 1 drink a day for females 2 - 4 mmHg
Increase potassium intake 4 - 5 servings of fruits and vegetables will usually provide 1500 to >3000 mg (38 to >77 mEq) of potassium per day 4 - 5 mmHg
Stop smoking ∼7 mmHg [1,5,6,47]



Medication class Compelling indication
ACE inhibitors diabetes, heart failure, kidney disease
Aldosterone antagonists heart failure, liver failure, resistant hypertension, acne
ARBs diabetes, heart failure, kidney disease
Alpha-2 agonists hypertensive urgency
Alpha blockers benign prostatic hyperplasia
Beta blockers heart failure, heart attack, angina, atrial fibrillation, esophageal varices
Calcium channel blockers angina, atrial fibrillation (nondihydropyridines), black patients
Loop diuretics heart failure, kidney failure, liver failure
Thiazide diuretics heart failure, calcium-based kidney stones, black patients
Vasodilators angina, heart failure, resistant hypertension