All patients should be counseled about the need for lifestyle modification: weight control; increased physical activity; alcohol moderation; sodium reduc- tion; and emphasis on increased consumption of fresh fruits, vegetables, and low-fat dairy prod- ucts.17,529 537 (Level of Evidence: B) 2. In patients with SIHD with BP 140/90 mm Hg or higher, antihypertensive drug therapy should be instituted in addition to or after a trial of lifestyle modifications.538 543 (Level of Evidence: A) 3. The specific medications used for treatment of high BP should be based on specific patient characteris- tics and may include ACE inhibitors and/or beta blockers, with addition of other drugs, such as thiazide diuretics or calcium channel blockers, if needed to achieve a goal BP of less than 140/ 90 mm Hg.544,545 (Level of Evidence: B) Hypertension is an important independent risk factor for ischemic cardiovascular events. Observational studies have demonstrated a continuous and graded relationship between BP and cardiovascular risk. In a collaborative meta-analysis of prospective studies of nearly 1 million adults without preexisting vascular disease, the risk of a vascular death increased linearly over the BP range of 115/75 mm Hg to 185/115 mm Hg, without a threshold effect. 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. 