Patients with stage 2 hypertension and BP 160/100 mm Hg should be promptly treated, carefully monitored, and subject to upward medication dose adjustment as necessary to control BP. Reassessment includes BP measurement, detection of orthostatic hypotension in selected patients (eg, older or with postural symptoms), identification of white coat hypertension or a white coat effect, documentation of adherence, monitoring of the response to therapy, reinforcement of the importance of adherence, reinforcement of the importance of treatment, and assistance with treatment to achieve BP target. ACC indicates American College of Cardiology; AHA, American Heart Association; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; CKD, chronic kidney disease; DM, diabetes mellitus; and RAS, renin-angiotensin system. over the course of their life spans.S8.1.2-12,S8.1.2-13 Although the numbers needed to treat with BP-lowering medications to prevent a CVD event in the short term are greater in young- er, lower-risk individuals with hypertension than in older, higher-risk adults with hypertension, the estimated gains in lifeexpectancyattributabletolong-termuseofBP-lowering medications are correspondingly greater in younger, low- er-risk individuals than in older adults with a higher risk of Indirect support is also provided by evi- dence from trials using BP-lowering medications to reduce the risk of developing higher levels of BPS8.1.2-59 S8.1.2-61 and, in one case, to achieve a reduction in LV mass.S8.1.2-62 In the HOPE-3 (Heart Outcomes Prevention Evaluation-3) BP Trial, there was no evidence of short-term benefit during treatment of adults (average age 66 years) with a relatively low risk of CVD (3.8% CVD event rate during 5.6 years of follow-up). However, subgroup analysis suggested benefit in those with an average SBP approximately >140 mm Hg (and a CVD risk of 6.5% during the 5.6 years of follow- We acknowledge the importance of excluding white coat hypertension before initiating pharmacological therapy in hypertensive patients with low ASCVD risk. 