Hypertension: a comprehensive review of risk factors, pathophysiology, complications, and treatment strategies

Vollständiger Abstract

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Hypertension is one of the most prevalent chronic noncommunicable diseases and represents a major public health challenge because of its high prevalence, silent progression, and close association with cardiovascular, cerebrovascular, and renal diseases. The aim of this narrative review was to synthesize the available scientific evidence on the risk factors, pathophysiological mechanisms, major complications, and therapeutic strategies for the comprehensive management of hypertension. To achieve this, a qualitative review was conducted using original research articles, systematic reviews, narrative reviews, clinical practice recommendations, and reports from international organizations published primarily between 2020 and 2026. The reviewed evidence demonstrates that hypertension is a multifactorial disease influenced by biological, behavioral, environmental, and socioeconomic factors. The principal determinants identified included obesity, aging, excessive sodium intake, physical inactivity, diabetes mellitus, chronic kidney disease, and inequalities in access to healthcare services. Furthermore, inadequate blood pressure was found to significantly increase the risk of left ventricular hypertrophy, heart failure, coronary artery disease, stroke, and chronic kidney disease. The findings support the implementation of patient centered models of care that integrate individualized pharmacological treatment, sustainable lifestyle modifications, health education, continuous clinical follow up, and multidisciplinary healthcare teams to optimize blood pressure control, reduce cardiovascular complications, and improve health outcomes.