Considering the high prevalence of hypertension among general population, the general practitioner is frequently challenged to start an antihypertensive therapy, which aims to lower blood pressure and to reduce the cardiovascular risk. At the initial stage, several critical questions must be asked : « Is a pharmacological treatment necessary ? », « Which are the target blood pressures ? » and « Which antihypertensive drug should be chosen to start therapy ? »The aim of this article is to give general practicioners some practical tools to guide them in the initial management of hypertensive patients.