Hypertension: a comprehensive review of risk factors, pathophysiology, complications, and treatment strategies
DOI:
https://doi.org/10.62452/rpwezm31Palavras-chave:
Hypertension, risk factors, cardiovascular complications, antihypertensive treatmentResumo
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.
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Azad, M. A. K., Sufian, M. A., Alsadder, L., Zaman, S., Hamzi, W., Ali, A., Hossain, M. Z., & Hamzi, B. (2025). Hypertension control in resource-constrained settings: Bridging socioeconomic gaps with predictive insights. International Journal of Cardiology Cardiovascular Risk and Prevention, 27, 200472. https://doi.org/10.1016/j.ijcrp.2025.200472
Borghi, C., & Cicero, A. F. G. (2007). New management strategies for the hypertensive patient: From the disease to the patient. European Cardiovascular Disease, 3(1), 103–104. https://doi.org/10.15420/ecr.2007.0.1.103
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and Control of Hypertension: JACC Health Promotion Series. Journal of the American College of Cardiology, 72(11), 1278–1293. https://doi.org/10.1016/j.jacc.2018.07.008
Chekol, H. R., Demissie, N. G., & Mekonnen, C. K. (2025). Awareness of hypertension-related complications and its determinants among adult hypertensive patients in Ethiopia. Frontiers in Cardiovascular Medicine, 12, Article 1563249. https://doi.org/10.3389/fcvm.2025.1563249
Dadi, T. A., Fikadu, S. K., & Gebre, A. E. (2025). Hypertension-related complications and associated factors among adult patients on follow-up at Asella referral and teaching hospital, Southeast Ethiopia. BMC cardiovascular disorders, 26(1), 25. https://doi.org/10.1186/s12872-025-05415-y
Elendu, C., Amaechi, D. C., Elendu, T. C., Amaechi, E. C., & Elendu, I. D. (2024). Dependable approaches to hypertension management: A review. Medicine, 103(24), e38560. https://doi.org/10.1097/MD.0000000000038560
Goorani, S., Zangene, S., & Imig, J. D. (2025). Hypertension: A Continuing Public Healthcare Issue. International Journal of Molecular Sciences, 26(1), 123. https://doi.org/10.3390/ijms26010123
Hinton, T. C., Adams, Z. H., Baker, R. P., Hope, K. A., Paton, J. F. R., Hart, E. C., & Nightingale, A. K. (2020). Investigation and treatment of high blood pressure in young people: Too much medicine or appropriate risk reduction? Hypertension, 75(1), 16–22. https://doi.org/10.1161/HYPERTENSIONAHA.119.13820
Lang, K., Van Iterson, E. H., & Laffin, L. J. (2021). Contemporary strategies to manage high blood pressure in patients with coexistent resistant hypertension and heart failure with reduced ejection fraction. Cardiology and Therapy, 10, 9–25. https://doi.org/10.1007/s40119-020-00203-5
Ma, J., Li, Y., Yang, X., Liu, K., Zhang, X., Zuo, X., Ye, R., Wang, Z., Shi, R., Meng, Q., & Chen, X. (2023). Signaling pathways in vascular function and hypertension: Molecular mechanisms and therapeutic interventions. Signal Transduction and Targeted Therapy, 8, 168. https://doi.org/10.1038/s41392-023-01430-7
Masenga, S. K., & Kirabo, A. (2023). Hypertensive heart disease: risk factors, complications and mechanisms. Frontiers in cardiovascular medicine, 10, 1205475. https://doi.org/10.3389/fcvm.2023.1205475
Nasution, A. N., Ginting, C. N., & Siregar, R. A. (2024). Important strategies for preventing hypertension through risk factor approaches. Indonesian Journal of Global Health Research, 6(1), 419–428. https://doi.org/10.37287/ijghr.v6i1.2689
Omer, S. A., Elamin, M. E. M. A., Mahgoub, A. M. A., Alwadi, M. Y., Alagib, D. A. F., Afaalah, O. M. O., Siddig, M. E. A., Elsayed, H. E. M., Mohamed, O. M. Y., Abdullah, A. A. O., Mohamed, R. A. A., Elsafi, A. A. M., Ahmed, S. E. M., & Faraj, N. F. R. (2024). Prevalence and associated risk factors of hypertension among adults with diabetes mellitus in Wad-Medani, Gezira State, Sudan 2023: A cross-sectional study. Biomedical Journal of Scientific & Technical Research, 58(5). https://doi.org/10.26717/BJSTR.2024.58.009228
Pop, C., Petriş, A. O., Pop, L., & David, L. E. (2025). Pillars of Blood Pressure Management in Patients with Type 2 Diabetes Mellitus: Insights from Recent Trials and Emerging Perspectives. Journal of Clinical Medicine, 14(10), 3269. https://doi.org/10.3390/jcm14103269
Puspitasari, N., Yonata, A., & Islami, S. (2026). Risk Factors and Complications of Uncontrolled Hypertension in Indonesia: Literature Review. Medical Profession Journal of Lampung, 16(3), 69-75. https://doi.org/10.53089/medula.v16i3.1822
Shiraly, R., Jeihooni, A. K., & Shirazi, R. B. (2022). Perception of risk of hypertension related complications and adherence to antihypertensive drugs: A primary healthcare based cross-sectional study. BMC Primary Care, 23, 303. https://doi.org/10.1186/s12875-022-01918-1
Sierra, C., & Coca, A. (2009). Developments in strategies for treating high-risk hypertension. European Cardiology, 5(1), 56–62. https://doi.org/10.15420/ecr.2009.5.1.56
Silva, B. V., Sousa, C., Caldeira, D., Abreu, A., & Pinto, F. J. (2022). Management of arterial hypertension: Challenges and opportunities. Clinical cardiology, 45(11), 1094–1099. https://doi.org/10.1002/clc.23938
Sood, M., Shende, R., Saha, S., & Eruva, V. (2024). Systematic review article: Study of risk factors for hypertension. European Journal of Cardiovascular Medicine, 14(6), 19–22. https://healthcare-bulletin.co.uk/article/systematic-review-article-study-of-risk-factors-for-hypertension-2526/
Verdecchia, P., Cavallini, C., & Angeli, F. (2022). Advances in the Treatment Strategies in Hypertension: Present and Future. Journal of Cardiovascular Development and Disease, 9(3), 72. https://doi.org/10.3390/jcdd9030072
World Health Organization. (2025). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
World Health Organization. (2025). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
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