Changes

** ACEI/ARB (good for kidney protection, don't do both), Dihydropyridine CCB (better for HTN) > non-dihydropyridine CCB (better for rate control), Beta Blockers (cardiac selective (MAN BABES) > non-selective), Thiazide-Like Diuretics > Thiazide-Type Diuretics.  

** ACEI/ARB (good for kidney protection, don't do both), Dihydropyridine CCB (better for HTN) > non-dihydropyridine CCB (better for rate control), Beta Blockers (cardiac selective (MAN BABES) > non-selective), Thiazide-Like Diuretics > Thiazide-Type Diuretics.  

** For most patients, the combination of ACEI/ARB + CCB is the best, so start with one of these two classes so that the second can be added later for synergy.  

** For most patients, the combination of ACEI/ARB + CCB is the best, so start with one of these two classes so that the second can be added later for synergy.  

** Special population considerations: [[CHF]] (avoid CCBs, use beta blockers, ACEI/ARBs, diuretics, spironolactone); [[CKD]] (use ACEI/ARB); Pregnancy (hydralazine, labetalol, nicardipine, methyldopa); post-MI (use beta blockers + ACEI/ARB, spironolactone); Blacks (CCB + thiazide-like diuretic); Cocaine ('''lorazepam''', don't give beta blockers due to unopposed alpha); BPH (diuretics, alpha 1 antagonists)

** Special population considerations: [[CHF]] (avoid CCBs, use beta blockers, ACEI/ARBs, diuretics, spironolactone); [[CKD]] (use ACEI/ARB); Pregnancy (hydralazine, labetalol, nicardipine, methyldopa); post-MI (use beta blockers + ACEI/ARB, spironolactone); Blacks (CCB + thiazide-like diuretic); Cocaine ('''lorazepam, don't give beta blockers due to unopposed alpha'''); BPH (diuretics, alpha 1 antagonists)

* Hypertensive Urgency BP > 180 + mild symptoms

* Hypertensive Urgency BP > 180 + mild symptoms

* Hypertensive Emergency BP > 180 + ominous symptoms

* Hypertensive Emergency BP > 180 + ominous symptoms