Taper dose to discontinue Clonidine patches may be useful in select patients May rarely cause bone marrow depression, positive Coombs test, hemolytic anemia and liver disorders (hepatitis, jaundice) a For complete drug information, review the manufacturer s prescribing information b DoD Basic Core Formulary item c HCTZ 12.5 mg may be considered as an initial dose with titration recommended to 25-50 mg daily; refer to Recommendation 25 and associated discussion for further information d Item not on VA National Formulary e Restricted to treatment of patients with systolic heart failure in VA Abbreviations: ACEI: angiotensin-converting enzyme inhibitor; AE: adverse effect; ARB: angiotensin II receptor blocker; AV: atrioventricular; bid: twice daily; BPH: benign prostatic hyperplasia; CCB: calcium channel blockers; CKD: chronic kidney disease; CV: cardiovascular; DHP: dihydropyridine; eGFR: estimated glomerular filtration rate; HCTZ: hydrochlorothiazide; HFrEF: heart failure with reduced ejection fraction; K+: potassium; LV: left ventricular; mL: milliliter; SLE: systemic lupus erythematosus; Appendix G: Guidance for Conducting Office Blood Pressure Measurement The following information has been adapted from the 2019 AHA Measurement of Blood Pressure in Properly prepare the patient Have the patient relax, sitting in a chair with feet flat on floor and back supported; the patient should be seated for 3-5 minutes without talking or moving around before recording the first blood pressure reading The patient should avoid caffeine, exercise, and smoking for at least 30 minutes before measurement Ensure that the patient has emptied his/her bladder Neither the patient nor the observer should talk during the rest period or during the measurement Remove clothing covering the location of cuff placement Measurements made while the patient is sitting on an examining table do not fulfill these criteria Use proper technique for blood pressure measurements Use an upper-arm cuff blood pressure measurement device that has been validated and ensure that the device is calibrated periodically Support the patient s arm (e.g.