The term prehypertension used in JNC 7 was not adopted by anyone else and also in Indian guidelines. JNC 8 2014 threshold and targets higher for age 60 was widely criticized. Issue of AOBP important since devices are expensive. The definition and classification of HT does not need to be changed. Longevity in India is less than US and same targets cannot be applied for the frail old individuals. Physicians should be oriented towards reducing risk in high risk individuals. Two latest guidelines have reacted less strongly to the SPRINT trial than the ACC AHA. We possibly need to follow this approach.