Risk of CHD is directly related to both systolic and diastolic blood pressure levels.  Meta-analysis of prospective data on over one million adults has shown that for adults aged 40 to 69 years, each 20mmHg increase in usual systolic blood pressure, or 10mmHg increase in usual diastolic blood pressure, doubles the risk of death from CHD. At older ages the increase in risk of death from CHD is smaller, around 50% increase for every 20mmHg increase in usual systolic or 10mmHg increase in diastolic blood pressure in adults aged 80 to 89 years.

Research from the World Health Organization suggests that the cardiovascular burden due to raised blood pressure may be greater than previously suggested. The World Health Report 2002 estimates that around 11% of all disease burden in developed countries is caused by raised blood pressure, and that over 50% of CHD and almost 75% of stroke in developed countries is due to systolic blood pressure levels in excess of the theoretical minimum (115mmHg).

More recently the INTERHEART study estimated that 22% of heart attacks in Western Europe and 25% of heart attacks in Central and Eastern Europe were due to a history of high blood pressure, and that those with a history of hypertension were at just under twice the risk of a heart attack compared to those with no history of hypertension.

The 2004 British Hypertension Society guidelines for hypertension management recommend that drug treatment should be considered for individuals with blood pressures of 140/90mmHg or over, and that optimal blood pressure treatment targets are a systolic blood pressure of less than 140mmHg and a diastolic blood pressure of less than 85mmHg (and lower still, at 130/85mmHg, in people with diabetes). People with high normal blood pressures 130-139/85-89mmHg should be assessed yearly. The optimal blood pressure level is now classified as <120/<80mmHg.

Both drug treatment and lifestyle changes - particularly weight loss, an increase in physical activity, and a reduction in salt and alcohol intake - can effectively lower blood pressure.