A CRITICAL REVIEW ON ESSENTIAL HYPERTENSION WITH SPECIAL REFERENCE TO LIFESTYLE AND PHARMACOLOGICAL MANAGEMENT

Authors

  • Dr. Sandeep Kumar
  • Dr. Dharmendra Kumar Mishra
  • Dr. Bindu Chauhan

DOI:

https://doi.org/10.22159/prl.ijayush.v15i06%20(June).2096

Keywords:

Essential Hypertension, Lifestyle Modification, Pharmacological Management, Blood Pressure Control, Cardiovascular Risk, Antihypertensive Drugs.

Abstract

Essential hypertension is one of the most common non-communicable disorders and remains a major risk factor for cardiovascular, cerebrovascular, and renal complications. It is usually multifactorial in origin, where genetic tendency, advancing age, obesity, high salt intake, sedentary lifestyle, stress, smoking, alcohol consumption, and unhealthy dietary habits play an important role. In most cases, no single identifiable cause is found, which makes long-term prevention and control highly dependent on lifestyle correction and regular medical management. Lifestyle modification is considered the first and most important step in the management of essential hypertension. Weight reduction, regular physical activity, salt restriction, balanced diet, stress control, adequate sleep, avoidance of tobacco, and moderation of alcohol intake help in reducing blood pressure and improving overall cardiovascular health. Along with lifestyle measures, pharmacological management is required in many patients to achieve proper blood pressure control and prevent target organ damage. Commonly used antihypertensive drugs include diuretics, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, and beta-blockers, selected according to patient condition, associated diseases, age, and risk profile. A combined approach of lifestyle correction and suitable pharmacological therapy gives better long-term results than either approach alone. This review highlights the importance of early diagnosis, patient education, regular monitoring, lifestyle discipline, and rational drug therapy in the effective management of essential hypertension.

References

World Health Organization. Hypertension. Geneva: World Health Organization; 2025 Sep 25. Available from: WHO Hypertension Fact Sheet. Accessed on 11 May 2026.

World Health Organization. Global report on hypertension: the race against a silent killer. Geneva: World Health Organization; 2023.

Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 21st ed. New York: McGraw Hill Education; 2022. p. 2036-2054.

Hall JE. Guyton and Hall Textbook of Medical Physiology. 14th ed. Philadelphia: Elsevier; 2021. p. 221-235.

Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension. 2018;71(6):e13-e115.

World Health Organization. Guideline for the pharmacological treatment of hypertension in adults. Geneva: World Health Organization; 2021.

Mancia G, Kreutz R, Brunstrom M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension. J Hypertens. 2023;41(12):1874-2071.

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104.

Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison’s Manual of Medicine. 20th ed. New York: McGraw Hill Education; 2020. p. 838-846.

Kumar P, Clark M. Kumar and Clark’s Clinical Medicine. 10th ed. Edinburgh: Elsevier; 2021. p. 1069-1083.

American College of Cardiology. 2017 guideline for high blood pressure in adults: ten points to remember. Washington DC: American College of Cardiology; 2018.

Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet. 2007;370(9587):591-603.

Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cifkova R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Primers. 2018;4:18014.

Carey RM, Muntner P, Bosworth HB, Whelton PK. Prevention and control of hypertension. J Am Coll Cardiol. 2018;72(11):1278-1293.

Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003;289(16):2083-2093.

Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the DASH diet. N Engl J Med. 2001;344(1):3-10.

Campbell NRC, Paccot Burnens M, Whelton PK, Angell SY, Jaffe MG, Cohn J, et al. 2021 World Health Organization guideline on pharmacological treatment of hypertension: policy implications for the region of the Americas. Lancet Reg Health Am. 2022;9:100219.

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Published

2026-06-07

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Section

Review Article