Because hypertension causes end-organ damage and cardiovascular disease, proper treatment is extremely important to prevent progression. Secondary and essential hypertension, respectively, are classified by whether the specific etiology is known or unknown. Secondary hypertension includes renal parenchymal hypertension, renovascular hypertension, and endocrine hypertension, among others. In essential hypertension, genetic and environmental factors and adaptations to neural, mechanical, and hormonal perturbations interact to raise blood pressure. In many cases of secondary hypertension, blood pressure can be effectively reduced by treating the etiology. Therefore, it is important to identify secondary hypertension. In patients with essential hypertension, treatment consists of lifestyle modification and appropriate drug therapy, with use of calcium channel blockers, angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, diuretics, and β blockers. Indications, contraindications, potential complications, and conditions that require the careful use of drugs must be considered. Although significant progress has been made in the treatment of hypertension, management is still often inadequate. Development of more effective treatments will result in improvements in quality of life and prognosis for patients with hypertension.
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