Guideline authors define hypertension in adults as a BP ≥ 130/80 mmHg when measured with a validated device under optimal conditions. A healthy lifestyle is recommended for all adults with hypertension. This means two or fewer drinks per day, less than 2 gms of salt per day and regular exercise, 150 to 300 minutes per week of moderate aerobic exercise. NB 70% of salt comes from ready-made food, including bread.
Weight loss is recommended, and increasing potassium intake, although care is needed with ACE/ARBs and spironolactone. Avoid smoking due to the increased risk of cardiovascular disease.
Treatment with or without medication should achieve a systolic BP of < 130 mmHg. Combination medicines are recommended in low doses, and first line includes ACE/ARB, thiazide or thiazide-like (e.g. chlorthalidone) and long-acting calcium channel blockers. If BP remains above 130 mm Hg systolic, consider adding spironolactone (monitor potassium).
