Largely on the basis of a prespecified subgroup analy- sis of the ALLHAT trial, the National Heart, Lung, and Blood Institute panel originally appointed to address hypertension management recommend that in the general black population, including those with diabetes mellitus, initial antihypertensive therapy should include a thiazide-type diuretic or a calcium Meschia et al Guidelines for the Primary Prevention of Stroke 3767 Population-wide approaches to reducing BP have also been advocated as more effective than approaches focused on screening individual patients for the presence of hypertension and treating them.235,260 Because the benefits of BP reduction can be seen across the range of measurements in the popula- tion, with and without pre-existing CVD, it may be reason- able to provide BP-lowering medications to all patients above a certain age (eg, 60 years of age).235 Similarly, on the basis of observational data from 19 cohorts with 177025 participants showing lower salt intake to be associated with a lower risk of stroke and other cardiovascular outcomes, population-wide reductions in salt intake may be advocated as a way to reduce Self-measured BP monitoring is recommended because with or without additional support such monitoring lowers BP compared with usual care.261 Hypertension: Summary and Gaps Hypertension remains the most important, well-documented modifiable stroke risk factor, and treatment of hypertension is among the most effective strategies for preventing both isch- emic and hemorrhagic stroke. Across age groups, including adults 80 years of age, the benefit of hypertension treatment in preventing stroke is clear. Reduction in BP is generally more important than the specific agents used to achieve this goal. Optimal BP targets for reducing stroke risk are uncer- tain. 