Use clinical judgement for people of any age with frailty or multimorbidity (see also NICE's guideline on multimorbidity). [2019] 1.4.10 Discuss starting antihypertensive drug treatment, in addition to lifestyle advice, with adults aged under 80 with persistent stage 1 hypertension who have 1 or more of the following: target organ damage established cardiovascular disease renal disease diabetes an estimated 10-year risk of cardiovascular disease of 10% or more. Use clinical judgement for people with frailty or multimorbidity (see also NICE's guideline on multimorbidity). [2019] 1.4.11 Discuss with the person their individual cardiovascular disease risk and their preferences for treatment, including no treatment, and explain the risks and benefits before starting antihypertensive drug treatment. Continue to offer lifestyle advice and support them to make lifestyle changes (see the section on lifestyle interventions), whether or not they choose to start antihypertensive drug treatment. [2019] 1.4.12 Consider antihypertensive drug treatment in addition to lifestyle advice for adults aged under 60 with stage 1 hypertension and an estimated 10-year risk below 10%. Bear in mind that 10-year cardiovascular risk may underestimate the lifetime probability of developing cardiovascular 1.4.13 Consider antihypertensive drug treatment in addition to lifestyle advice for people aged over 80 with stage 1 hypertension if their clinic blood pressure is over 150/90 mmHg. Use clinical judgement for people with frailty or multimorbidity (see also NICE's guideline on multimorbidity). 1.4.14 For adults aged under 40 with hypertension, consider seeking specialist evaluation of secondary causes of hypertension and a more detailed assessment of the long-term balance of treatment benefit and risks. For a short explanation of why the committee made the 2019 recommendations and how they might affect practice, see the rationale and impact section on starting antihypertensive drug treatment. 