Titrate to target by comorbidity. Initial 2-drug combo in stage 2 or >20/10 above goal. Resistant HTN → spironolactone 4th-line. Confirm out-of-office BP.
Authored pathway active · cardio.htn.outpatient.outpatient
Titrate to target by comorbidity. Initial 2-drug combo in stage 2 or >20/10 above goal. Resistant HTN → spironolactone 4th-line. Confirm out-of-office BP.
Guidelines: 2025 ACC/AHA Guideline for the Management of High Blood Pressure · SPRINT 2015 (NEJM) · ACCOMPLISH 2008 (initial 2-drug combo)
Phenotypes (8)
- Primary (essential) hypertension
- Resistant HTN (≥ 3 agents incl. diuretic, BP not at goal)
- HTN with CKD (eGFR < 60 or UACR ≥ 30)
- HTN with type-2 diabetes
- +4 more
Red flags (6)
- Hypertensive emergency (SBP > 180 or DBP > 120 with acute end-organ damage)CRITICAL
- Papilledema or grade III–IV hypertensive retinopathyCRITICAL
- AKI after ACEi/ARB initiation (Cr rise ≥ 30% from baseline)HIGH
- Severe hyperkalemia (K ≥ 6.0 mmol/L)CRITICAL
- +2 more
Pathway-scoped symptom and exam intake
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Uses LR engine cardio.htn.core.v1, then routes suggested engines into the workspace.
19-panel workspace
cardio.htn.outpatient · OutpatientStart patient workup
Open a scratch or linked encounter, add active problems, then keep labs, fluids, acid-base, and electrolyte tools beside the main workspace instead of losing context.
Encounter and problems
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Multi-window tools
Unified
labs + fluids + acid-base
Labs
fast lab analyzer
Fluid
resuscitation and balance
Electrolytes
Na/K/Mg/Phos/Ca
ABG/VBG
compensation and mixed disorders
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