Hypertension is a chronic elevation of arterial blood pressure that significantly increases the risk of heart attack, stroke, heart failure, kidney disease and cognitive decline. It is common worldwide and often silent, progressing for years without symptoms while damaging blood vessels and organs.

Blood pressure is determined by cardiac output and vascular resistance. Key mechanisms include overactivation of the sympathetic nervous system, dysregulation of the renin angiotensin aldosterone system, endothelial dysfunction, increased arterial stiffness and impaired sodium handling in the kidneys. Genetic predisposition interacts with environmental factors such as high salt intake, excess body weight, physical inactivity, alcohol use, smoking and chronic stress.

Research highlights the importance of out of office measurement with home and ambulatory monitoring to detect masked hypertension and white coat hypertension, and to better predict cardiovascular risk. Lower treatment targets than in the past are supported for many high risk individuals, provided therapy is well tolerated.

Lifestyle interventions are foundational. Evidence supports reducing dietary sodium, following eating patterns rich in fruits, vegetables and low fat dairy, maintaining healthy body weight, exercising regularly, limiting alcohol and not smoking. These measures can reduce blood pressure by amounts comparable to a single medication in some people.

Pharmacologic treatment commonly involves combinations of thiazide type diuretics, calcium channel blockers, ACE inhibitors or angiotensin receptor blockers, tailored to comorbidities such as diabetes or chronic kidney disease. Long term studies show that effectively treating hypertension lowers rates of myocardial infarction, stroke, heart failure and death, confirming that early detection and sustained control are crucial for prevention.