Each increment of 20 mm Hg in systolic BP or 10 mm Hg in diastolic BP was associated with a doubling of risk.546 RCTs indicate that treatment results in a reduction of cardiovascular risk consistent with predictions Treatment of high BP should begin with lifestyle measures. Maintenance of an appropriate body weight (BMI ,25 ) is a key element of the nonpharmacological strategies recommended to improve BP control; weight loss of 10 kg typically results in a decrease in BP of 5 to 20 mm Hg.529 531,548,549 Consumption of a diet rich in fruits, vegeta- bles, and low-fat dairy products532,533; reduction of dietary sodium intake529,531,533,534,550; regular physical activity535; and moderation of alcohol consumption536 also result in signifi- cant lowering of BP. In many patients with SIHD, therapy with medications will be required to lower BP to the desired level. Treatment trials have definitively demonstrated a beneficial effect of antihy- pertensive drug therapy on cardiovascular disease risk. An overview of 17 placebo-controlled trials, most of which focused on lowering diastolic BP, showed that reducing diastolic BP 5 to 6 mm Hg (or an estimated 10 to 20 mm Hg in systolic BP) within a population was associated with a significant reduction in vascular mortality, with approxi- mately 40% reduction in stroke and 20% reduction in coronary events.547 This benefit of treatment also has been observed in studies of older adult patients with isolated Despite the plethora of clinical studies, the appropriate BP threshold for initiating medical therapy and specific treatment goals for patients with chronic IHD remain controversial. 