Avoid abrupt discontinuation of clonidine, which may induce hypertensive crisis; clonidine must be tapered to avoid rebound hypertension. Clonidine patch 0.1 0.3 1 weekly Direct vasodilators Hydralazine 100 200 2 or 3 These are associated with sodium and water retention and reflex tachycardia; use with a diuretic and beta blocker. Hydralazine is associated with drug-induced lupus-like syndrome at higher doses. Minoxidil is associated with hirsutism and requires a loop diuretic. Minoxidil can induce pericardial effusion. *Dosages may vary from those listed in the FDA-approved labeling (available at https://dailymed.nlm.nih.gov/dailymed/) From Chobanian et al JNC 7.S8.1.4-15 ACE indicates angiotensin-converting enzyme; ARB, angiotensin receptor blocker; BP, blood pressure; BPH, benign prostatic hyperplasia; CCB, calcium channel blocker; CKD, chronic kidney disease; CNS, central nervous system; CVD, cardiovascular disease; ER, extended release; GFR, glomerular filtration rate; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; IHD, ischemic heart disease; IR, immediate release; LA, long-acting; and SR, sustained release. Table 18. Continued Class Drug Usual Dose, Range (mg/d)* Daily Frequency Comments assigned to different BP targetsS8.1.5-3 S8.1.5-5 and in larger meta- analyses that additionally included trials that compared dif- ferent intensities of treatment.S8.1.5-12 Data from the most demonstrate a linear association between mean achieved SBP and risk of CVD mortality with the lowest risk at 120 to 124 mm Hg. The totality of the available information pro- vides evidence that a lower BP target is generally better than a higher BP target and that some patients will benefit from an SBP treatment goal <120 mm Hg, especially those at high risk The specific inclusion and exclusion criteria of any RCT may limit extrapolation to a more general population with hypertension. 