- Office cuff SBP ≥ 160 mmHg measured per protocol instructions (Appendix IV) following at least one (1) month of maximally tolerated therapy with at least three (3) anti-hypertensive medications, of which at least one (1) must be a diuretic unless patient has history of intolerance, ineffectiveness or contraindications. Any combination medications will be counted per the active ingredient (for example, Zestoretic (Lisinopril +HCTZ) equals two (2) anti-hypertensive medications)