Lesson Objectives:

• Apply the latest ACC/AHA hypertension and lipid guidelines.

• Identify first-line pharmacologic therapy for hypertension and hyperlipidemia.

• Discuss lifestyle interventions and their impact.

Hypertension Management (ACC/AHA 2017 Guidelines)

🔹 BP Classification:

• Normal: <120/80 mmHg

• Elevated: 120-129/<80 mmHg

• Hypertension Stage 1: 130-139/80-89 mmHg

• Hypertension Stage 2: ≥140/90 mmHg

🔹 First-Line Antihypertensive Therapy
✔️ ACE inhibitors/ARBs – for HTN with CKD, diabetes, heart failure.
✔️ Thiazide diuretics (HCTZ, chlorthalidone) – first-line in general population.
✔️ CCBs (amlodipine, diltiazem) – preferred in African-American patients.
✔️ Beta-blockers – for CAD, heart failure.

Dyslipidemia Management (ACC/AHA 2018 Guidelines)

🔹 LDL Goals:

• Very high risk (ASCVD, diabetes, prior MI): LDL <70 mg/dL.

• Moderate risk: LDL <100 mg/dL.

🔹 Lipid-Lowering Therapy
✔️ Statins (first-line):

• High-intensity (atorvastatin 40-80 mg, rosuvastatin 20-40 mg) for ASCVD.

• Moderate-intensity for lower-risk patients.
  ✔️ Ezetimibe & PCSK9 inhibitors – for patients not reaching LDL targets.

🔹 Lifestyle Modifications
✅ DASH diet (low sodium, high potassium, whole foods).
✅ Aerobic exercise (150 min/week).
✅ Weight loss (target BMI <25).