In the general population younger than 60 years, initiate pharma- cologic treatment to lower BP at DBP of 90 mm Hg or higher and treat to a goal DBP of lower than 90 mm Hg. For ages 30 through 59 years, Strong Recommendation Grade A For ages 18 through 29 years, Expert Opinion Grade E Recommendation 2 is based on high-quality evidence from 5 DBPtrials(HDFP,Hypertension-StrokeCooperative,MRC,ANBP,and VA Cooperative) that demonstrate improvements in health out- Initiation of antihypertensive treatment at a DBP threshold of 90 Hg reduces cerebrovascular events, heart failure, and overall mor- ing patients to a goal of either 80 mm Hg or lower or 85 mm Hg or which patients were randomized to these 3 goals without statisti- cally significant differences between treatment groups in the pri- In adults younger than 30 years, there are no good- or fair- qualityRCTsthatassessedthebenefitsoftreatingelevatedDBPon health outcomes (question 1, evidence statement 14). In the ab- senceofsuchevidence,itisthepanel sopinionthatinadultsyounger than 30 years, the DBP threshold and goal should be the same as in adults 30 through 59 years of age. In the general population younger than 60 years, initiate pharma- cologic treatment to lower BP at SBP of 140 mm Hg or higher and treat to a goal SBP of lower than 140 mm Hg. Expert Opinion Grade E Box. Recommendations for Management of Hypertension In the general population aged 60 years, initiate pharmacologic treat- ment to lower blood pressure (BP) at systolic blood pressure (SBP) 150 mm Hg or diastolic blood pressure (DBP) 90 mm Hg and treat to a goal SBP <150 mm Hg and goal DBP <90 mm Hg. (Strong Recommendation Grade A) Corollary Recommendation high BP results in lower achieved SBP (eg, <140 mm Hg) and treatment is welltoleratedandwithoutadverseeffectsonhealthorqualityoflife,treat- ment does not need to be adjusted. 