Hypertension Unraveled: From Mechanisms to Modern Management

Hypertension remains the leading preventable risk factor for cardiovascular and renal morbidity worldwide, affecting nearly one-third of adults. Its etiopathogenesis is multifactorial, involving genetic predisposition, neurohormonal dysregulation, renal dysfunction, vascular remodeling, metabolic abnormalities, and environmental influences. Recent advances in diagnostics—including ambulatory blood pressure monitoring, wearable sensors, artificial intelligence, and biomarker discovery—have improved early detection and risk stratification. Pharmacotherapy continues to evolve beyond traditional agents such as thiazides, ACE inhibitors, ARBs, and calcium-channel blockers, with novel drugs including endothelin receptor antagonists, aldosterone synthase inhibitors, RNA interference therapies, and nonsteroidal mineralocorticoid receptor antagonists showing promising results in resistant and high-risk populations. Non- pharmacological strategies, including sodium restriction, weight reduction, physical activity, and the DASH diet, remain the cornerstone of management and prevention. Population-level interventions, precision medicine approaches, and digital health integration further enhance control and adherence. Collectively, these innovations highlight a paradigm shift toward individualized, multi-modal hypertension care, aimed at reducing the persistent global burden of cardiovascular complications.