The primary objective in hypertension (HTN) management treatment is to decrease blood pressure (BP) to less than 140/90 mm Hg.  This goal may be lower in patients with diabetes mellitus (DM) or renal disease with proteinuria.

·         Clinical management should begin by prescribing lifestyle modifications in all patients with HTN.  Non-pharmacologic measures can control BP or decrease the amount of required medication in most patients.

·         If lifestyle modification alone is used as initial therapy, the trial should be relatively short (no longer than 6 to 12 months), with frequent monitoring.  Drug therapy should be instituted if blood pressure goals are not attained. 

·         Once effective control has been achieved, follow-up can be scheduled at three to six month intervals.  Periodic follow up is important for management of the hypertensive patient and to assess the long-term response to therapy, monitor the development of target organ damage, and reinforce lifestyle modifications.