Hypertension

Hypertension has high prevalence in the general population, accounts for one in every eight consultations in primary care and is a major risk factor for cardiovascular and renal disease. Despite the wide availability of suitable medicines, only about 25% of all hypertensive patients have their blood pressure controlled adequately. Effective management of patients with hypertension mandates assessment for asymptomatic target organ damage and also for potential secondary causes. Accurate blood pressure measurement is crucial for diagnosis and may require recordings to be made in the clinic and at home, as well as use of ambulatory methods. Treatment is dependent not only on blood pressure level but also on total cardiovascular risk. Evidence-based treatment algorithms exist to simplify the approach to treatment and most patients require at least two medicines to achieve control. Severely elevated blood pressure can lead to acute organ failure that requires emergency treatment but routine management of hypertension relies on the careful combination of different classes of drug and titration of dosage.