A large retrospective population-based analysis showed that waiting until patients’ systolic blood pressure levels exceeded 150 mmHg to start intensive antihypertensive therapy was associated with an increased risk of acute cardiovascular events and death. In addition, patients who delayed giving intensive antihypertensive therapy for 6 weeks had a similar increased risk of cardiovascular events and death as those who delayed follow-up after adjusting their medications. The study was published online in the Feb. 5 issue of the British Medical Journal. Principal investigator Wenxin Xu (Beth Israel Deaconess Medical Center, Harvard Medical School, Boston) and others noted that this study aimed to determine the optimal time between hypertension testing and escalation of antihypertensive therapy, and between intensive antihypertensive therapy and follow-up blood pressure measurements. There are few data on this, and even information on the optimal timing of intervention in patients with stage I hypertension is lacking. And the treatment of patients with systolic blood pressure 140 to 149 mmHg is still highly controversial. The investigators analyzed data from the UK Health Improvement Network database of 88,756 patients with hypertension who presented to a primary care physician. Follow-up was 3 years after a treatment strategy evaluation period. Intensive treatment was defined as increasing the dose of a drug or adding another drug. Overall, patients were at lower risk of cardiovascular events or death once intensive antihypertensive therapy was required to be given in a shorter period of time. Patients with a 1.4-month delay in giving the appropriate treatment after finding systolic blood pressure levels above the intensive antihypertensive threshold had a 12% increased risk of cardiovascular events or death; patients who were followed up only after a 2.7-month delay after receiving intensive antihypertensive treatment had a significant 18% increased risk of the composite endpoint.