Hypertension is a chronic elevation of blood pressure that significantly increases the risk of heart attack, stroke, heart failure, kidney disease, and cognitive decline. It often develops silently over many years, with no symptoms until complications occur. Diagnosis relies on repeated, standardized blood pressure measurements, ideally including home or ambulatory monitoring to detect white coat and masked hypertension.

Research shows that both systolic and diastolic pressures matter, but systolic pressure above 130 to 140 mmHg in mid and late life is particularly predictive of cardiovascular events. Even “high normal” values are associated with higher long term risk. Multiple factors contribute, including genetic variants, obesity, high salt intake, low potassium intake, physical inactivity, alcohol use, chronic stress, and aging related vascular stiffness. The renin angiotensin aldosterone system, sympathetic nervous system activity, and endothelial dysfunction all play key roles in its development.

Lifestyle interventions can meaningfully reduce blood pressure. Evidence supports weight reduction, regular aerobic and resistance exercise, limiting sodium, increasing dietary potassium, and adopting dietary patterns rich in fruits, vegetables, whole grains, and unsalted nuts. Avoiding tobacco and moderating alcohol intake further lowers risk.

When lifestyle measures are insufficient, medications markedly reduce heart attack, stroke, and mortality. Large trials support the use of diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and beta blockers, often in combination. More intensive treatment targets can yield additional benefit for high risk patients, though very low pressures may cause adverse effects in some groups. Overall, research indicates that early detection and sustained blood pressure control across adulthood are crucial for preventing long term organ damage and improving survival.