High systolic blood pressure (SBP) remains a leading global risk factor for disability and death ahead of smoking and high body-mass index.1 In the UK, high blood pressure is responsible for 75,000 deaths annually, underlies half of all strokes and myocardial infarctions, and is a significant risk factor for heart failure, kidney disease and dementia.2 Data from observational studies suggest that an increase in usual blood pressure above 115/75mmHg is associated with an increased risk of vascular mortality;3 lower than perhaps most people appreciate and lower than the threshold for treatment in current UK hypertension …