Let me quote a case which I take to be one of an habitual high range of arterial pressure very well borne, but upon which any accession of tension is hazardous. A gentleman of splendid physique, aged 74, height 6 ft 3 in, weight 17 stone, of calm temperament, a soldier and a sportsman in the past, has been under my observation for some fifteen years. His average health has been excellent. He has presented slight gouty symptoms from time to time, but the kidneys are healthy. He suffers occasional giddiness when walking or turning quickly in bed. There  is some naso-pharyngeal catarrh which is liable to extend to the larger bronchial tubes. For the past eight years his blood pressure has been observed to be high; 180, 200, 170 and 160 as the lowest maximum with diastolic 90-100. The pulse ranges 72-80.The vessels are good, the gums are sound.