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This is defined as left ventricle of heart enlarged; angina; transient ischaemia attacks (TIAs); stroke; peripheral vascular disease; heart attack; kidney function impaired.

Where the initial blood pressure is systolic ≥ 220mmHg OR diastolic ≥ 120mmHg, treat immediately.

Where the initial blood pressure is systolic 200–219 mmHg OR diastolic 110–119 mmHg, confirm over one to two weeks then treat if these values are sustained.

Where the initial blood pressure is systolic 160–199 mmHg OR diastolic 100–109 mmHg, AND the patient has cardiovascular complications, end organ damage or diabetes (type I or II), confirm over three to four weeks then treat if these values are sustained.

Where the initial blood pressure is systolic 160–199 mmHg OR diastolic 100–109 mmHg, but the patient has NO cardiovascular complications, end organ damage or diabetes, advise lifestyle changes, reassess weekly initially and treat if these values are sustained on repeat measurements over four to twelve weeks.

Where the initial blood pressure is systolic 140–159 mmHg OR diastolic 90–99 mmHg, AND the patient has cardiovascular complications, end organ damage or diabetes, confirm within four to twelve weeks and treat if these values are sustained.

Where the initial blood pressure is systolic 140–159 mmHg OR diastolic 90–99 mmHg, but the patient has NO cardiovascular complications, end organ damage or diabetes, advise lifestyle changes, reassess monthly; if mild hypertension persists, treat if the risk of coronary heart disease is greater than or equal to 15 per cent over the next 10 years using the Joint British Societies Coronary Risk Prediction Charts (which give a predicted future CHD risk depending on age, gender, smoking status, systolic blood pressure, cholesterol levels and diabetic status).