At what systolic blood pressure do you recommend a person 73 years old who does not show any thickening of the heart walll to go on medication?

Above 140mmHg: Assuming the patient is in otherwise good health and can tolerate treatment. The patient would benefit from treating levels consistently above 140 mmhg.

140: A healthy 73 year-old likely has another 20+ good years to go. Even mild hypertension can damage the heart. You may need only a simple medication like a diuretic. Follow your doctor's advice. Wish you many years of good health!

Depends: In general terms, people with a systolic blood pressure consistently above 140mmhg and/or a diastolic pressure over 85mmhg need treatment to lower their blood pressure. Even if the patient shows no signs of atherosclerosis, I am sure there is some present. I just would go slow on lowering the pressure so the patient does not have se of the medication. Don't forget a dash diet and exercise!