■      Begin with a nonpharmacologic approach (see Table 46.2).

■      Use a low-dose diuretic as the first choice for initial pharmacologic therapy.

■      Base alternative drug selection or combination therapies on individual patient characteristics.

■      When initiating drug therapy, begin at half of the usual dose, increase dose slowly, and continue nonpharmacologic therapies.

■      Focus treatment goal on systolic blood-pressure reduction to 135 to 140 mm Hg.

■      Avoid excessive reduction in diastolic blood pressure (below 70 mm Hg).

■      Do not use aggressive therapy whenever adverse effects (eg, postural hypotension) cannot be avoided.