Clinical recommendationEvidence ratingReferences
Combination therapy may be considered as the initial therapy to treat blood pressure that is more than 20/10 mm Hg over goal.B1, 3, 4
Combination therapy may be equally or better tolerated than higher doses of an individual component of the combination therapy.B4, 7, 12
The recommended initial treatment for hypertensive patients with heart failure or previous myocardial infarction includes a beta blocker and an ACE inhibitor.A1, 31, 32
For patients in whom an ACE inhibitor is recommended, an angiotensin receptor blocker may be substituted if the ACE inhibitor is not tolerated or is contraindicated.A1, 31
Recommended hypertension treatment for recurrent stroke prevention includes an ACE inhibitor and a diuretic.A1
Initial treatment of hypertension with an ACE inhibitor is recommended in patients with diabetes and chronic kidney disease.A1