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High blood pressure BP is a major public health problem in India and its prevalence is rapidly increasing among urban and rural populations. Reducing systolic and diastolic BP can decrease cardiovascular risk and this can be achieved by non-pharmacological lifestyle measures as well as pharmacological means. Lifestyle changes should be the initial approach to hypertension management and include dietary interventions reducing salt, increasing potassium, alcohol avoidance, and multifactorial diet control, weight reduction, tobacco cessation, physical exercise, and stress management. A number of pharmaceutical agents, well evidenced by large randomized clinical trials, are available for initial treatment of high BP. These include older molecules such as thiazide diuretics and beta-blocking agents and newer molecules, dihydropyridine calcium channel blockers CCB, angiotensin converting enzyme ACE inhibitors, and angiotensin receptor blockers ARB. In view of the recent clinical trials data, some international guidelines suggest that CCB, ACE inhibitors or ARB and not beta-blockers or diuretics should be the initial therapy in hypertension management. Comprehensive hypertension management focuses on reducing overall cardiovascular risk by lifestyle measures, BP lowering and lipid management and should be the preferred initial treatment approach. High blood pressure BP is a major public health problem in India and elsewhere 1 — 4.