Recommendation 9 is asummaryofstrategiesbasedonexpertopinionforstartingandadd- ingantihypertensivedrugs.Theevidencestatementssupportingthe recommendations are in the online Supplement. Table 1. Comparison of Current Recommendations With JNC 7 Guidelines Topic JNC 7 2014 Hypertension Guideline Methodology Nonsystematic literature review by expert committee including a range of study designs Recommendations based on consensus Critical questions and review criteria defined by expert panel with input from methodology team Initial systematic review by methodologists restricted to RCT evidence Subsequent review of RCT evidence and recommendations by the panel according to a standardized protocol Definitions Defined hypertension and prehypertension Definitions of hypertension and prehypertension not addressed, but thresholds for pharmacologic treatment were defined Treatment goals Separate treatment goals defined for uncomplicated hypertension and for subsets with various comorbid conditions (diabetes and CKD) Similar treatment goals defined for all hypertensive populations except when evidence review supports different goals for a particu- lar subpopulation Lifestyle recommendations Recommended lifestyle modifications based on literature review and expert opinion Lifestyle modifications recommended by endorsing the evidence- based Recommendations of the Lifestyle Work Group Drug therapy Recommended 5 classes to be considered as initial therapy but rec- ommended thiazide-type diuretics as initial therapy for most pa- tients without compelling indication for another class Specified particular antihypertensive medication classes for patients with compelling indications, ie, diabetes, CKD, heart failure, myocar- dial infarction, stroke, and high CVD risk Included a comprehensive table of oral antihypertensive drugs in- cluding names and usual dose ranges Recommended selection among 4 specific medication classes (ACEI or ARB, CCB or diuretics) and doses based on RCT evidence Recommended specific medication classes based on evidence review for racial, CKD, and diabetic subgroups Panel created a table of drugs and doses used in the outcome trials Scope of topics Addressed multiple issues (blood pressure measurement methods, patient evaluation components, secondary hypertension, adherence to regimens, resistant hypertension, and hypertension in special populations) based on literature review and expert opinion Evidence review of RCTs addressed a limited number of questions, those judged by the panel to be of highest priority. 