Hypertension

Hypertension is the sustained elevation of blood pressure above evidence-based thresholds. Current major guidelines (ACC/AHA 2017) define it as systolic ≥130 mmHg or diastolic ≥80 mmHg on repeated measurements. The World Health Organization estimates 1.28 billion adults globally have hypertension, and about half don't know it — "the silent killer" earned its nickname honestly. Untreated hypertension drives atherosclerosis, left-ventricular hypertrophy, chronic kidney disease, retinopathy, and roughly doubles the lifetime risk of stroke. The encouraging side: blood-pressure control is one of the most-evidence-supported interventions in all of medicine — every 10 mmHg drop in systolic pressure cuts stroke risk by ~27% and coronary disease by ~17%.

• Creatinine + eGFR — screening for hypertensive nephropathy; both deteriorate as kidney damage progresses.
• Potassium — important before and during diuretic / ACE-inhibitor / ARB therapy.
• Sodium — usually unremarkable unless diuretic-related.
• HbA1c, fasting glucose — type 2 diabetes amplifies hypertensive risk.
• LDL cholesterol — central to the overall cardiovascular risk calculation.
• Urine albumin/creatinine ratio — earliest sign of hypertensive kidney damage; should be checked annually.

Hypertension is asymptomatic in the vast majority of patients — symptoms only appear when blood pressure is dangerously high or end-organ damage has occurred. Possible presentations:

• Severe headache (usually only at very high pressures)
• Visual changes
• Chest discomfort, palpitations
• Shortness of breath
• Blood in urine

Most cases are caught by routine screening, which is exactly why screening cadence matters.