We recommend a target for aerobic exercise of at least 120 minutes per week for reduction in blood pressure. Strong for Not Reviewed, Amended c. Dietary Modifications 20. We recommend a dietitian-led Dietary Approaches to Stop Hypertension Diet for the treatment or prevention of hypertension for patients with hypertension or interested patients with other cardiovascular risk factors. Strong for Not Reviewed, Amended 21. In patients with hypertension, we recommend that sodium intake be limited to no more than 2,300 mg/day (100 mmol/day), with referral to a dietitian or other support as appropriate. Strong for Not Reviewed, Not Changed 22. In patients with additional cardiovascular risk factors, such as dyslipidemia, we suggest considering a dietitian-led Mediterranean Diet as an alternative to the Dietary Approaches to Stop Hypertension Diet. Weak for Not Reviewed, Not Changed Topic Sub- topic # Recommendation Strengtha Categoryb Pharmacological Treatment a. For Hypertension 23. We recommend offering a thiazide-type diuretic, calcium channel blocker, or either an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker as primary pharmacologic therapy for hypertension for reduction in composite cardiovascular outcomes. Strong for Reviewed, New-replaced 24. In African American patients with hypertension, we recommend against using an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker as monotherapy. Strong against Not Reviewed, Not Changed 25. In hypertensive patients 65 years and over, we suggest a thiazide- type diuretic for reduction in composite cardiovascular outcomes. Weak for Reviewed, New-added 26. We recommend against more than one of the following three drug classes together in the same patient: angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or direct renin inhibitors. Strong against Not Reviewed, Not Changed 27. For the treatment of hypertension, there is insufficient evidence to recommend for or against initiating combination therapy over initiating monotherapy with the sequential addition of another medication. 