Treatment of hypertension

1. Big picture

The treatment of hypertension is not just “lower the number.” The real goal is to prevent stroke, myocardial infarction, heart failure, chronic kidney disease, retinopathy, aortic dissection, and premature cardiovascular death.

Clinical logic:

Confirm true hypertension
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Estimate total cardiovascular risk + target-organ damage
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Lifestyle treatment for everyone
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Choose drug therapy according to risk, comorbidities, contraindications
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Monitor BP response, kidney function, potassium, adverse effects
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Escalate stepwise if not controlled

The 2024 European Society of Cardiology guideline keeps hypertension as office BP ≥140/90 mmHg, introduces “elevated BP” as 120–139/70–89 mmHg, and recommends more intensive treatment targets in many treated patients if tolerated. ([European Society of Cardiology][1])

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