Conclusions Itisimportanttonotethatthisevidence-basedguidelinehasnotre- nition from JNC 7 remains reasonable. The relationship between naturallyoccurringBPandriskislineardowntoverylowBP,butthe benefitoftreatingtotheselowerlevelswithantihypertensivedrugs is not established. For all persons with hypertension, the potential benefits of a healthy diet, weight control, and regular exercise can- notbeoveremphasized.Theselifestyletreatmentshavethepoten- tial to improve BP control and even reduce medication needs. Al- Table 6. Guideline Comparisons of Goal BP and Initial Drug Therapy for Adults With Hypertension Guideline Population Goal BP, mm Hg Initial Drug Treatment Options guideline General 60 y <150/90 Nonblack: thiazide-type diuretic, ACEI, ARB, or CCB General <60 y <140/90 Black: thiazide-type diuretic or CCB Diabetes <140/90 Thiazide-type diuretic, ACEI, ARB, or CCB CKD <140/90 ACEI or ARB General nonelderly <140/90 -Blocker, diuretic, CCB, ACEI, or ARB General elderly <80 y <150/90 Diabetes <140/85 ACEI or ARB CKD no proteinuria <140/90 ACEI or ARB CKD + proteinuria <130/90 General <80 y <140/90 Thiazide, -blocker (age <60y), ACEI (nonblack), or ARB Diabetes <130/80 ACEI or ARB with additional CVD risk ACEI, ARB, thiazide, or DHPCCB without addi- tional CVD risk CKD <140/90 ACEI or ARB Diabetes <140/80 ACEI or ARB CKD no proteinuria 140/90 ACEI or ARB CKD + proteinuria 130/80 General <80 y <140/90 <55 y: ACEI or ARB General 80 y <150/90 55 y or black: CCB Black, lower risk <135/85 Diuretic or CCB Target organ damage or CVD risk Abbreviations: ADA, American Diabetes Association; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; CHEP, Canadian Hypertension Education Program; CKD, chronic kidney disease; CVD, cardiovascular disease; DHPCCB, dihydropyridine calcium channel blocker; ESC, European Society of Cardiology; ESH, European Society of Hypertension; ISHIB, International Society for Hypertension in Blacks; JNC, Joint National Committee; KDIGO, Kidney Disease: Improving Global Outcome; NICE, National Institute for Health and Clinical Excellence. 