The guidelines of the European society of hypertension and the European society of cardiology have been updated. With regard to antihypertensive treatment, diuretics, beta-blockers, calcium antagonists, angiotensin converting enzyme inhibitors and angiotensin II antagonists are still considered as first line options. Treatment may also be initiated using a fixed dose combination containing two agents lowering blood pressure by different mechanisms. This is particularly true in patients with systolic blood pressure > 160 mmHg and/ or diastolic blood pressure >90 mmHg, as well as in those with high cardiovascular risk.