- 🔬Pathophysiology
- Multifactorial ↑ systemic vascular resistance &/or cardiac output; most cases primary (essential). Sustained ↑afterload → LVH, vascular remodeling, end-organ damage.
- 🩺Signs & Symptoms
- Usually asymptomatic ('silent killer'), found on screening. End-organ clues: retinopathy, LVH, proteinuria. Severe: headache, visual changes.
- 🎯Gold Standard Diagnosis
- ≥2 elevated readings on ≥2 separate visits. AHA/ACC 2025: Stage 1 130–139/80–89, Stage 2 ≥140/90. Confirm with home/ambulatory BP.
- 💊First-line Treatment
- Lifestyle + a first-line class: thiazide-type diuretic, ACEi, ARB, or long-acting dihydropyridine CCB. ACEi/ARB as part of treatment in CKD with moderate–severe albuminuria. Start 2 classes (single-pill combination) in stage 2.