(Strong Recommendation Grade A) Corollary Recommendation high BP results in lower achieved SBP (eg, <140 mm Hg) and treatment is welltoleratedandwithoutadverseeffectsonhealthorqualityoflife,treat- ment does not need to be adjusted. (Expert Opinion Grade E) In the general population <60 years, initiate pharmacologic treatment to 30-59 years, Strong Recommendation Grade A; For ages 18-29 years, Expert Opinion Grade E) In the general population <60 years, initiate pharmacologic treatment to Opinion Grade E) In the population aged 18 years with chronic kidney disease (CKD), ini- Opinion Grade E) SBP <140 mm Hg and goal DBP <90 mm Hg. (Expert Opinion Grade E) In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic, cal- cium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). (Moderate Recommenda- tion Grade B) In the general black population, including those with diabetes, initial anti- hypertensivetreatmentshouldincludeathiazide-typediureticorCCB.(For generalblackpopulation:ModerateRecommendation GradeB;forblack patients with diabetes: Weak Recommendation Grade C) In the population aged 18 years with CKD, initial (or add-on) antihyper- tensive treatment should include an ACEI or ARB to improve kidney out- comes.ThisappliestoallCKDpatientswithhypertensionregardlessofrace or diabetes status. (Moderate Recommendation Grade B) Themainobjectiveofhypertensiontreatmentistoattainandmaintaingoal BP.IfgoalBPisnotreachedwithinamonthoftreatment,increasethedose of the initial drug or add a second drug from one of the classes in recom- continue to assess BP and adjust the treatment regimen until goal BP is reached. If goal BP cannot be reached with 2 drugs, add and titrate a third drugfromthelistprovided.DonotuseanACEIandanARBtogetherinthe same patient. If goal BP cannot be reached using only the drugs in recom- drugs to reach goal BP, antihypertensive drugs from other classes can be used. Referral to a hypertension specialist may be indicated for patients in whomgoalBPcannotbeattainedusingtheabovestrategyorfortheman- agement of complicated patients for whom additional clinical consulta- tion is needed. 