In Japan starting with any one of six classes of medications including: CCB, ACEI/ARB, thiazide diuretics, beta-blockers, and alpha-blockers is deemed reasonable, while in Canada and Europe all of these but alpha-blockers are recommended as options.
Če ciljni krvni tlak ni dosežen, je treba zdravljenje spremeniti, saj je terapevtska vztrajnost jasna ovira za nadzor krvnega tlaka.