Systemic Hypertension: Definition, Classification, Risk Factors, Blood Pressure Assessment, and Hypertension-Mediated Organ Damage

Abstract

Hypertension (HTN) is a highly prevalent chronic condition and one of the major modifiable risk factors for cardiovascular disease, stroke, and renal impairment. It is commonly diagnosed when office systolic blood pressure is ≥140 mmHg and/or diastolic blood pressure is ≥90 mmHg, with home and ambulatory blood pressure monitoring providing additional diagnostic information. Its prevalence increases with age and is frequently associated with other cardiovascular risk factors, including obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome. Persistent elevation of blood pressure can lead to hypertension-mediated organ damage involving the heart, brain, kidneys, blood vessels, and eyes, thereby increasing cardiovascular morbidity and mortality. Accurate blood pressure measurement, appropriate classification, and comprehensive cardiovascular risk assessment are essential for early diagnosis and effective management. Furthermore, distinguishing primary from secondary hypertension is important for identifying potentially treatable underlying causes. This review aims to summarize the definition, classification, epidemiology, and major risk factors of hypertension, with particular emphasis on blood pressure measurement, cardiovascular risk stratification, and hypertension-mediated organ damage. It also highlights the clinical importance of early detection, assessment of associated comorbidities, and appropriate management strategies to minimize long-term cardiovascular and renal complications.