Mechanisms linking hypertension to cardiovascular and cerebrovascular diseases and their clinical implications: A comprehensive review

Hypertension, one of the most prevalent chronic conditions worldwide, stands as a principal risk factor for cardiovascular and cerebrovascular diseases, including coronary heart disease and stroke. Recent advances have clarified a graded, dose-response relationship in which higher blood pressure is consistently associated with increased vascular event risk, with relative risks commonly ranging from modest elevations (~1.2) at the lower end of above-optimal blood pressure to substantially higher levels (>3.0) in more severe hypertension categories. This review synthesizes current evidence on how hypertension influences the incidence and progression of cardiovascular and cerebrovascular diseases, emphasizing its interplay with comorbid conditions such as obesity, metabolic syndrome, pregnancy-induced hypertension, and sleep apnea. Additionally, it explores the impact of blood pressure management targets on the prevention of adverse vascular events and evaluates the safety and efficacy of pharmacological treatments in diverse patient populations. Environmental contributors and their role in modulating disease risk are also addressed. By integrating epidemiological data with clinical research findings, this article aims to provide a comprehensive theoretical framework and practical guidance for the prevention and management of cardiovascular and cerebrovascular complications in hypertensive patients.