The risk of cardiovascular morbidity and mortality increases in proportion to the arterial pressure at all ages and in both sexes. Most authorities regard blood pressure above 140 mmHg systolic, 90 mmHg diastolic as abnormal. The absolute risk of raised blood pressure is greater in men than women, men being more liable to coronary disease. Raised blood pressure predisposes to stroke, cardiac ischaemia and heart failure, progressive renal failure, retinal lesions and malignant hypertension. Lowering the blood pressure reduces the risks of these complications. Non-drug measures which can help and are worth considering before drug therapy include regular meditation, sodium restriction, weight reduction, and cessation of cigarette smoking. The efficacy of these is however less well proven than that of drug treatment. This article discusses when drug treatment should be considered. Barritt1 presents the arguments in more detail.
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