Hypertension

Hypertension has a high prevalence in the general population, accounts for 1 in 8 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 hypertensive patients have their blood pressure adequately controlled. Effective management of patients with hypertension mandates assessment for asymptomatic target organ damage and 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 using ambulatory methods. Treatment depends 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 medications to achieve control. Severely elevated blood pressure can lead to acute organ failure that requires emergency treatment. Routine management of hypertension relies, however, on careful combination of different classes of drug and titration of dosage.