This presentation will review the updated information on diagnosis and management of hypertension， based on the document published at the end of 2009 in the Journal of Hypertension.Five major areas will be addressed by the presentation， i.e.:
1. Assessment of organ damage and related total cardiovascular risk
2. Blood pressure thresholds and goals of treatment.
3. Therapeutic strategies.
4. Combination drug treatment.
5.Treatment of associated clinical conditions and the polypill.
Particular emphasis will be given to blood pressure thresholds and treatment goals considering that the 2009 update document recommends that systolic blood pressure should be lowered below 140 mmHg (and diastolic to 90 mmHg) in all hypertensive patients， irrespective of their grade of risk. On the basis of the results of recent clinical studies it appears to be prudent to lower blood pressure to values within the range 130-139 for systolic and 80-85 for diastolic. The choice of the antihypertensive drug treatment to be employed in a given patient should be based on the patient’s history and presence of associated risk factors including organ damage. Metabolic profile may also be important， taking into account that some drug classes may have deleterious metabolic effects， particularly of pro-diabetogenic nature (diuretics and beta-blockers).
Emphasis will be then given to the concept that an effective blood pressure control can only be achieved with combination drug treatment. The 2009 updated guidelines document recommends this treatment strategy， which may offer advantages over monotherapy and at treatment initiation， particularly in high risk patients in which an early blood pressure control is indicated.
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