Table 6. Generalizability of intensive blood pressure-lowering: cautions and contraindications
eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure.
Limited or no evidence

  • Heart failure (ejection fraction < 35%) or recent myocardial infarction (within past 3 months)
  • Indication for, but not currently receiving, a b-blocker
  • Frail or institutionalized elderly individuals

 
Inconclusive evidence

  • Diabetes mellitus
  • Previous stroke
  • eGFR < 20 mL/min/1.73 m 2

 
Contraindications

  • Patient unwilling or unable to adhere to multiple medications
  • Standing SBP < 110 mm Hg
  • Inability to measure SBP accurately
  • Known secondary cause(s) of hypertension