For this population the mainstay of treatment is lifestyle advice. Yet it is this population that carries much of the disease burden caused by high blood pressure. Pharmacological treatment is not recommended for individuals with systolic blood pressure <140 mm Hg (130 mm Hg for patients with established cardiovascular disease). Hypertension guidelines 2 emphasize the importance of primary prevention of hypertension for, because hypertension is established, long-term drug therapy is required and despite this the risk of cardiovascular disease events remains greater than in the normotensive population. Subjects with high normal blood pressure are at twice the risk of developing hypertension than those with lower values and therefore over time are at greater risk of events and may require antihypertensive medication in the future.

1 Thus, the risk of an event in subjects with high normal systolic blood pressure (130–139 mm Hg) is double that of subjects with optimal systolic blood pressure (<120 mm Hg). The relationship between blood pressure and risk of stroke and other cardiovascular events is continuous down to a systolic blood pressure of 115 mm Hg each 20 mm Hg increment of systolic blood pressure doubles the risk of such events across the entire blood pressure range from 115/75 to 185/115 mm Hg.

Do isometric exercises