A 2020 vision of hypertension

Hypertension is a common chronic disease affecting a large section of the general population. Hypertension is highly prevalent in the elderly because blood pressure (BP) rises with age. The risk of developing hypertension increases with predisposing genes, intrauterine growth retardation, prematurity and childhood obesity. BP is easier to control in the young. Non-pharmacological treatment through lifestyle changes, such as weight control and leisure-time physical activity, is more likely to be successful in young people. Hypertension in older adults is more difficult to control, requiring the use of more than one antihypertensive drug. Adverse effects and compliance become problematic. Much research is now directed at novel ways of controlling BP such as denervation. The change in definition of hypertension in the American guideline highlights the need to identify and manage hypertension early, at a stage when it is potentially reversible.