Epidemiological data have demonstrated a strong relationship between blood pressure (BP) and cardiovascular disease (CVD) risk and have shown the importance of systolic BP (SBP) as a determinant of such risk. The importance of BP as a risk factor has been further emphasized by a World Health Organization (WHO) report which identified high BP as one of the most important preventable causes of premature morbidity and mortality in developed and developing countries. There is now data available on the safety and effectiveness of different classes of BP-lowering drugs, including diuretics, angiotensin-converting enzyme inhibitors (ACE-Is), dihydropyridine and non-dihydropyridine calcium channel blockers (CCBs), beta-blockers and angiotensin receptor blockers (ARBs). In this review we discuss classification of BP stages, goal of therapy, lifestyle modifications and optimal BP control in individual patients. The detection and optimal treatment of hypertension is likely to significantly ameliorate CVD risk.