What are the target blood pressure parameters for a patient taking lisinopril (angiotensin-converting enzyme inhibitor) and amlodipine (calcium channel blocker)?

Blood Pressure Targets for Patients Taking Lisinopril and Amlodipine

For patients taking lisinopril and amlodipine, the target blood pressure should be <130/80 mmHg if it can be safely attained. 1

General Blood Pressure Targets

The combination of lisinopril (an ACE inhibitor) and amlodipine (a calcium channel blocker) is an effective regimen for blood pressure control. When determining appropriate blood pressure targets, consider the following:

• For most adults with hypertension, including those on combination therapy with lisinopril and amlodipine, the recommended target blood pressure is <130/80 mmHg 1
• This target is supported by multiple guidelines, including the 2017 ACC/AHA guidelines and the 2025 American Diabetes Association standards of care 1
• The International Society of Hypertension (ISH) 2020 guidelines similarly recommend a target of <130/80 mmHg for most patients 1

Patient-Specific Considerations

Blood pressure targets may need adjustment based on specific patient characteristics:

• Patients with diabetes: Target blood pressure should be <130/80 mmHg 1
• Patients with chronic kidney disease: Target blood pressure should be <130/80 mmHg 1
• Elderly patients (≥65 years): Target systolic blood pressure should be <130 mmHg if tolerated, but therapy should be deintensified if blood pressure falls below 90/60 mmHg 1
• Patients with cardiovascular disease or 10-year ASCVD risk ≥10%: Target blood pressure should be <130/80 mmHg 1

Monitoring and Adjustment

When managing patients on lisinopril and amlodipine:

• Blood pressure should be measured at every routine clinical visit, or at least every 6 months 1
• After initiation of therapy, monthly evaluation of adherence and therapeutic response is recommended until control is achieved 1
• Home blood pressure monitoring can be valuable for assessing treatment effectiveness between office visits 1

Efficacy of Lisinopril and Amlodipine Combination

The combination of lisinopril and amlodipine offers several advantages:

• This combination provides complementary mechanisms of action that effectively lower blood pressure through different pathways 2, 3
• Studies show that the combination of lisinopril and amlodipine can achieve significant blood pressure reductions, with mean systolic reductions of 17.5 mmHg or greater 3, 4
• The combination therapy is more effective than either agent alone in achieving target blood pressure goals 3, 5

Potential Concerns and Monitoring

When managing patients on this combination:

• Monitor for potential adverse effects, including edema (more common with amlodipine) and dry cough (more common with lisinopril) 2, 5
• In patients with renal impairment, more careful monitoring may be needed, though amlodipine does not require dose adjustment in renal failure 6
• For black patients, be aware that calcium channel blockers like amlodipine may be more effective than ACE inhibitors like lisinopril when used as monotherapy, but the combination can be particularly effective 1

Clinical Pearls

• If blood pressure remains uncontrolled on the combination of lisinopril and amlodipine, consider adding a thiazide-like diuretic as a third agent 1
• Avoid reducing systolic blood pressure below 120 mmHg as this may increase adverse events without providing additional cardiovascular benefit 1
• For patients with stage 2 hypertension (≥160/100 mmHg), prompt treatment and careful monitoring are essential until control is achieved 1