Patient handout

Hypertension (chronic management)

PRODUCTION

1. Your condition

This handout is for hypertension (chronic management). Your care team identified this based on: office bp ≥130/80 (us) or ≥140/90 (esc) — confirmed.

Other reasons your team may use this plan: home / abpm elevated per acc/aha 2017 §5; known htn — titration / monitoring visit per acc/aha 2017 §9; resistant htn ≥3 meds with diuretic per acc/aha 2017 §9.1.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
amlodipine	2.5–5 mg	PO	once daily; titrate to 10 mg	2025 AHA — first-line; ALLHAT/ACCOMPLISH; well tolerated
lisinopril	5–10 mg	PO	once daily; titrate to 40 mg	Compelling indications — RAAS-preferred per ACC/AHA 2017 Class I; HOPE (Yusuf NEJM 2000)
losartan	50 mg	PO	once daily; titrate to 100 mg	LIFE trial (Dahlöf Lancet 2002) — alternative if ACEi cough or angioedema; ACC/AHA 2017 Class I
chlorthalidone	12.5 mg	PO	once daily; titrate to 25 mg	2025 AHA prefers chlorthalidone over HCTZ — ALLHAT

Plan: 2025 AHA/ACC HTN — 4-tier stepwise add-on titration

3. Your action plan

Use these zones to know what to do based on how you feel.

GREEN — At goal — average home BP <130/80 (or personalised target) per ACC/AHA 2017 §8

If you have:

7-day morning + evening home BP average <130/80 per ACC/AHA 2017 §5
No symptoms of orthostasis, fatigue, or new headache per ACC/AHA 2017 §5

Do this:

Continue all current medications per ACC/AHA 2017 §9
Continue DASH diet, low-sodium intake, exercise per ACC/AHA 2017 §6.2
Bring home BP log to next visit per ESC/ESH 2023 §4
Annual labs (BMP, lipid, A1c, urine ACR) per ACC/AHA 2017 §6

YELLOW — Caution — average home BP 130–159/80–99 OR new mild symptoms per ACC/AHA 2017 staging

If you have:

7-day average 130–159/80–99 per ACC/AHA 2017 Stage 1–2 thresholds
Occasional readings ≥160/100 but not sustained per ESC/ESH 2023 §4
Mild new headache, fatigue, or peripheral edema per ACC/AHA 2017 §8 ADR monitoring

Do this:

Check technique (cuff size, position, rest 5 min, no caffeine/cigarette in 30 min) per ACC/AHA 2017 §5
Review medication adherence (missed doses?) per AHA 2020
Reduce salt; avoid NSAIDs and decongestants per ACC/AHA 2017 §6.2
Call provider within 1 week for titration per ACC/AHA 2017 §9

Call your provider if:

Home BP average >150/95 for ≥3 days per ACC/AHA 2017 §9
Side effects (cough, dizziness, swelling, AKI symptoms) per ACC/AHA 2017 §8
Pregnancy planned or suspected per ACOG 2019

RED — Medical alert — BP ≥180/120 OR end-organ symptoms per ACC/AHA 2017 §11

If you have:

BP ≥180/120 on home device on ≥2 readings 5 min apart per ACC/AHA 2017 §11
Severe headache, vision change, chest pain, dyspnea, weakness, slurred speech, confusion per ACC/AHA 2017 §11 end-organ signs
New shortness of breath, swelling, oliguria per ACC/AHA 2017 §11
Pregnancy + BP ≥160/110 OR severe-features symptoms per ACOG 2019

Do this:

Call 911 / go to ED immediately if any end-organ symptom per ACC/AHA 2017 §11
If asymptomatic and BP >180/120: take home meds as prescribed, recheck in 30 min, call provider same day per ACC/AHA 2017 §11
Do NOT self-administer extra doses unless action plan specifically allows per ACC/AHA 2017
Bring all medication bottles to ED for reconciliation per AHA 2020

Call your provider if:

Any red zone trigger — call now, do not wait for office hours per ACC/AHA 2017 §11

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

BP ≥180/120 with end-organ damage (chest pain, dyspnea/pulm edema, neuro deficit, AKI, retinopathy) per ACC/AHA 2017 §11(life-threatening)
BP ≥180/120 without acute target-organ damage — "severe hypertension" (2025 AHA/ACC HBP retires the term "hypertensive urgency")
Pregnancy confirmed in patient on ACEi/ARB/MRA — ACC/AHA 2017 Class III

5. Follow-up

Visit cadence by control + comorbidity per ACC/AHA 2017 §9; ASCVD prevention bundle

6. Sources

Guideline: 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM HBP Guideline (retires 2017) + ESC 2024 + KDIGO 2021 BP in CKD + ADA 2026