Hypertension

Hypertension is a condition characterized by persistently elevated blood pressure, defined as systolic blood pressure at or above 130 mmHg or diastolic blood pressure at or above 80 mmHg on repeated measurements, according to many contemporary guidelines. It is a major risk factor for cardiovascular disease, stroke, kidney disease, and eye problems, and it affects a large portion of adults worldwide. Blood pressure tends to increase with age and is influenced by genetics, lifestyle, and comorbidities.

Diagnosis usually requires multiple readings on separate occasions and may include home blood pressure monitoring or ambulatory blood pressure monitoring to confirm true hypertension and exclude white coat or masked hypertension.

Hypertension is commonly classified as primary (essential) hypertension with no single identifiable cause, accounting for most cases, and secondary hypertension, caused by an underlying condition such as kidney disease, endocrine disorders, or certain medications.

Management focuses on reducing cardiovascular risk through lifestyle changes and medications. Lifestyle measures include weight reduction, regular physical activity, a diet rich in fruits, vegetables, and low in saturated fat (the DASH diet), limiting sodium intake, moderating alcohol, and quitting tobacco. Pharmacologic therapy typically includes thiazide diuretics, ACE inhibitors, ARBs, or calcium channel blockers as first-line options, with combination therapy as needed. Treatment aims to lower blood pressure toward guideline targets while minimizing side effects and monitoring adherence.

Untreated hypertension increases the risk of heart attack, stroke, heart failure, kidney disease, and vision loss. With appropriate management, the risk of complications can be reduced, though hypertension often requires long-term ongoing care and regular monitoring.