ISSN: 2634 - 6796

Journal of Cardiology Research

Reviews & Reports

Review Article Open Access

Hypertension: A Comprehensive Review

Seema Thakur1*, Baljeet Singh1 and Neha Srivastava2
1
Associate Professor, Faculty of Pharmaceutical Sciences, PCTE Group of Institutes, Ludhiana, Punjab, India

2
School of Pharmaceutical Sciences, RIMT University, Mandi Gobindgarh, Punjab, India

ABSTRACT
Hypertension, often known as high blood pressure, is a prevalent and serious global health problem. It is a chronic disorder characterized by chronically
high blood pressure levels, which can lead to serious problems such as cardiovascular disease, stroke, and renal failure. The purpose of this review article
is to offer a full overview of hypertension, including epidemiology, etiology, pathophysiology, diagnosis, therapy, and preventative strategies. Furthermore,
the study delves into the most recent advances in hypertension research, developing therapy options, and the significance of lifestyle changes in controlling
this illness. A solid knowledge of hypertension is essential for healthcare practitioners and researchers in developing effective therapies to control and avoid
its negative effects.

*Corresponding author
Seema Thakur, Associate Professor, Faculty of Pharmaceutical Sciences, PCTE Group of Institutes, Ludhiana, Punjab, India.

Received: December 13, 2024; Accepted: December 18, 2024; Published: December 31, 2024
Introduction • Unusual levels of hormones controlling blood pressure [3]
Hypertension
Systemic arterial hypertension is characterized by persistently
high blood pressure in the systemic arteries. BP is commonly
expressed as the ratio of the systolic BP i.e. the pressure that the
blood exerts on the arterial walls when the heart contracts and the
diastolic BP i.e. the pressure when the heart relaxes [1].

Hypertension is a common disease seen among the public and the

early detection of it is significant for early treatment. There are
many risks associated with hypertension.
Figure 2: Pictorial Description on Types of Hypertensions
Hypertension is depicted as systolic blood pressure higher than
120 mmHg or diastolic blood pressure higher than 80 mmHg [2]. Epidemiology and Global Burden of Hypertension
• Worldwide, 1.28 billion individuals between the ages of 30
and 79 are predicted to have hypertension, while the majority
of them residing in countries with low or middle incomes.
• Adults with hypertension are reportedly 46% less likely to
be aware of their illness.
• Adults with hypertension are only recognized and treated in
42% of cases.21% of persons who have hypertension have it
under control. Around the world, hypertension is a key factor
in early mortality.
Figure 1: Pictorial Description on Hypertension • The reduction of hypertension prevalence by 33% between
2010 and 2030 is one of the worldwide objectives for non-
Types of Hypertensions communicable illnesses [4].
There are two types of hypertensions
• Primary Hypertension: High blood pressure that is not Risk Factors Associated with Hypertension
related to another medical condition. • Obesity: The more flow of blood you require to provide
• Secondary Hypertension: Another medical condition that oxygen and nourishment to your tissues, heftier you are.
causes high blood pressure, usually occurring in the kidneys, The pressure inside your arteries rises when more blood is
arteries, heart, or endocrine system. pumped through your blood vessels [5].
• Eating Too Much Sodium: Your body might store fluid
Examples include primarily as a consequence of eating too much salt, which
• Sleep problems like sleep apnea also causes your arteries to narrow. Blood pressure is raised
• Blocked renal arteries in the kidneys by both circumstances [6].

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Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

• Eating Too Little Potassium: When sodium levels in your cytokines and natural hormones that relax blood vessels and
cells are out of balance, potassium helps. Potassium reduces reduce blood pressure. Being overweight is also a greater
blood pressure by relaxing the smooth muscle cells in your possibility when you don't exercise [12].
arteries [7]. • Smoking: Some studies have found that smoking may
• Physically Inactive: Exercise improves blood flow across contribute to hypertension, especially in men over the age
all of the body's arteries, which triggers the production of of 45.
cytokines and natural hormones that relax blood vessels and Cigarette smoking has a complicated influence on blood
reduce blood pressure. Being overweight is also a greater pressure, including evidence indicating it raises blood
possibility when you don't exercise [7]. pressure acutely and increases the risk of Reno-vascular,
• Stress: A significant yet brief rise in blood pressure can be malignant, and hidden hypertension [13].
caused by elevated levels of stress. By increasing your intake,
smoking, or drinking alcohol while trying to relax, you can Secondary Hypertension and Underlying Medical Condition
only make your high blood pressure issues worse. Effective • Kidney Disease: Kidneys play an important part in
blood pressure-lowering methods include meditation and maintaining a healthy blood pressure. Kidney disease reduces
relaxation approaches [8]. the ability of the kidneys to assist control blood pressure.
• Decongestants: Common congestion relievers included in Blood pressure rises as a result. If you have chronic renal
cough and cold medications include pseudo-ephedrine and disease, high blood pressure increases the likelihood that
phenylephrine. These drugs narrow the arteries, which raise the illness may worsen and lead to cardiac complications.
blood pressure and heart rate [9]. • Hormonal Disorders: Many hormones in our body work
together in order to control the blood pressure. When the
Etiology of Hypertension balance of these hormones is off, we might experience a
Genetic Factors change in your blood pressure.
The heritability of hypertension is widely recognized, and as a Example: Trouble with the thyroid gland and adrenals can
result, several investigations ranging from genetic linkage analyses lead to high blood pressure [14].
to genome-wide association studies are currently being conducted
to better understand the etiology of both monogenic and polygenic Pathophysiology of Hypertension
forms of hypertension. However, due to the complexity of essential Renin-Angiotensin Aldosterone System
hypertension, single genes regulating blood pressure variability • The renin-angiotensin-aldosterone system is a set of chemical
still need to be explored, putting the development of single-gene- events that assist control blood pressure.
focused treatment challenging. Certain genes in your DNA are • When blood pressure drops (to 100 mm Hg or below for
linked to a higher risk for hypertension. Although there is little systolic), the kidneys release the enzyme renin into the
we can do to change our genetics, it’s important to know about circulation.
your family history. There are also certain physical conditions that • Renin shreds angiotensinogen, a big protein that circulates in
you may be born with that can raise your blood pressure. These the circulation. Angiotensin-1 is one component.
include problems with the aorta and other blood vessels, which • Angiotensin-converting enzyme, also known as ACE,
are usually diagnosed in childhood [10]. breaks down angiotensin I, which is generally inactive.
One component is angiotensin II, a highly active hormone.
Angiotensin II constricts the muscle walls of tiny arteries
(arterioles), raising blood pressure. Angiotensin II additionally
prompts the adrenal glands to secrete aldosterone and the
pituitary gland to release vasopressin (antidiuretic hormone).
• The kidneys retain sodium (salt) when aldosterone and
vasopressin are present. Aldosterone also increases potassium
excretion in the kidneys. The increased salt induces water
retention, which raises blood volume and blood pressure [15].

Figure 3: Genetic Factors of Hypertension

Lifestyle Factors
• Diet: Unhealthy eating habits and lack of physical exercise
are responsible for around 30% of preventable fatalities
and morbidity from non-communicable illnesses, including
morbidity and mortality from hypertension. Hypertension is
a disorder that raises the risk of stroke, heart failure, renal
failure, and peripheral vascular disease.
Excessive consumption of saturated and trans-fatty acids,
as well as increased consumption of salt and sugar are risk
factors for cardiovascular disease, including hypertension
[11]. Figure 4: RAAS
• Physical Inactiveness: Exercise improves blood flow across
all of the body's arteries, which triggers the production of

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Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

Sympathetic Nervous System and Vasoactive Substances pressure through its effects on blood vessel tone, the kidneys, and
• A variety of genetic disorders have been linked to the the immune system [18].
mechanisms of essential hypertension. These genes are linked
to vasoactive chemicals. On the other hand, the kidney's Diagnosis
responsibilities in the etiology of hypertension have long Mercury Sphygmomanometer
been recognized. • Patient Condition: BP should be taken in a calm, warm
• Vasoactive chemicals and autonomic nerves have an impact environment. Sitting pressures are advised for routine follow-
on renal function, namely natriuresis. The autonomic nervous up; the patient should sit quietly for five minutes with the
system compensates for blood pressure fluctuations generated back supported and the arm supported at the level of the
by vasoactive drugs. However, those alterations in blood heart. Caffeine and exogenous adrenergic stimulants should
pressure seldom last more than a day. Other processes, such be avoided for an hour before the reading, and smoking
as the central nervous system resetting the baroreceptor should be avoided for 30 minutes beforehand. If feasible,
response, are required to retain blood pressure at a higher the blood pressure should be checked 30-60 minutes before
level in order to maintain hypertension. taking antihypertensive medicines to estimate the trough or
• That is, vasoactive chemicals may have an effect on the central nadir impact.
nervous system. In fact, we discovered that practically all • Equipment: Mercury sphygmomanometers give the most
vasoactive drugs have an effect on the central nervous system, precise blood pressure reading. The bladder should wrap and
causing changes in sympathetic nervous system activity. I cover two-thirds of the length of the arm; if not, position the
evaluated the method by which vasoactive chemicals affect bladder over the brachial artery to prevent excessive readings
long-term blood pressure levels, which is tied to the central from a bladder that is too small.
nervous system [16]. • Technique & Guidelines: When taking blood pressure, the
cuff ought to be inflated to a pressure roughly 30 mmHg
Endothelial Dysfunction and Oxidative Stress higher than systolic, as determined by palpation of the pulse in
The involvement of the vascular endothelium in the development the brachial artery. Palpation-based systolic pressure estimate
of hypertension is not easily defined. In reaction to flowing reduces possible difficulties with an auscultatory gap. As the
blood, a quiescent healthy endothelium constantly produces cuff is deflated, the Korotkoff noises go away. After the cuff
strong vasodilators, which have the ability to directly decrease has been suitably inflated, proceed as follows:
vascular resistance. Endothelial dysfunction is a disorder that
includes both decreased endothelium-dependent vasodilation and 1. Because excessive pressure might enhance turbulence and
increased endothelial inflammatory activity, although endothelial prolong the disappearance of sound, the stethoscope should
dysfunction is widely established as a predictor of atherosclerosis be positioned softly over the brachial artery. As a result, the
progression and future cardiovascular events, its significance in diastolic pressure measurement may be artificially decreased
hypertension is less clear [17]. by up to 15 mmHg. The patient's arm should always be
supported at the level of the heart when taking their blood
pressure. Allowing the patient's arm to dangle down when
sitting or standing results in the brachial artery being 15 cm
below the heart. As a result of the extra hydrostatic pressure
caused by gravity, the measured BP will be raised by 10-15
mmHg.
2. The cuff should be gently deflated at a rate of 2 to 3 mmHg
each heartbeat. The systolic pressure is the pressure at which
the brachial pulse may be palpated for the first time when
blood flow is restored through the previously compressed
artery; it is also the pressure at which the pulse is first heard
by auscultation (Korotkoff phase 1).
3. The pulse continues to be heard as the cuff is deflated below
the systolic pressure until there is abrupt muffling (phase 4)
Figure 5: Role of Endothelial Dysfunction in Hypertension. and, approximately 8 to 10 mmHg later, disappearance of
sound (phase 5), although the point of muffling sound should
Inflammation and Immune System Involvement be used in patients with a difference of more than 10 mmHg
In recent decades, research has revealed that a weakened immune between phases 4 and 5.
system and inflammation play a role in hypertension. Experiments 4. Initially, the blood pressure should be monitored in both arms.
on animal models have revealed that immune cells such as If there is a discrepancy owing to a unilateral artery lesion,
dendritic cells, macrophages, and lymphocytes have a role in the employ the arm with the higher pressure.
development and maintenance of hypertension. In hypertension, 5. Each visit, the blood pressure should be measured at least
infiltrating inflammatory immune cells in the kidney induce salt twice, with one or two minutes between measures to allow
retention, renal fibrosis, glomerular damage, and chronic kidney trapped blood to be released. If the second value deviates
disease, all of which lead to high blood pressure. Similarly, from the first by more than 5 mmHg, more measures should
immune cells and inflammatory cytokines have a role in the be taken until a stable value is obtained. The figure entered
structural and functional alterations of blood arteries associated on the patient's chart should be the average of the previous
with hypertension. two measurements [19].

A weakened immune system and persistent low-grade systemic

inflammation increase SNS activity, which leads to high blood

J Cardiol Res Rev Rep, 2024 Volume 5(6): 3-8

Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

• Cardiovascular Diseases: High blood pressure (BP) is a

major risk factor for cardiovascular disease (CVD), which is
the main cause of death. High blood pressure is responsible
for around 54% of strokes and 47% of coronary heart disease
globally [24].
• Cerebrovascular Disease: Hypertension increases the risk
of stroke by worsening atherosclerosis in the aortic arch
and cervicocerebral arteries, causing arteriosclerosis and
lipohyalinosis in the small-diameter penetrating cerebral
end arteries, and promoting heart disease, which can be
complicated by stroke [25].
• Renal Complications: High blood pressure can constrict and
restrict blood vessels, causing them to become damaged and
Figure 6: Diagnosis of BP. weak throughout the body, including the kidneys. Blood flow
is reduced because to the constriction. If the blood arteries
Ambulatory Monitoring in your kidneys are damaged, they may no longer function
A longer blood pressure monitoring test may be done to check correctly [26].
blood pressure at regular times over six or 24 hours. This is called
ambulatory blood pressure monitoring. However, the devices used Treatment of Hypertension
for the test aren't available in all medical centers. Lifestyle Modifications
Lifestyle modifications that effectively lower blood pressure is
Ambulatory blood pressure monitoring takes 24-hour measures • DASH Diet: The DASH diet emphasizes on fruits, vegetables,
of your blood pressure (BP), whether you're awake or asleep. and whole grains. Dairy items that are fat-free or low-fat, fish,
This occurs outside of your doctor's office, as you go about your poultry, beans, and nuts are all included. The diet restricts
normal activities. A cuff on your arm and a tiny gadget linked to meals high in salt, often known as sodium. It also restricts
a strap or belt are worn [20]. additional sugar and saturated fat, which are commonly found
in fatty meats and full-fat dairy products.
• Increased physical activity
• Weight loss
• Limited alcohol consumption
• Relaxation techniques of Yoga, Acupuncture
• Mindfulness‐based stress‐reduction program [27].

Pharmacological Treatment
Drug therapy is needed if lifestyle modifications cannot adequately
bring BP to goal.

First-line medications used in the treatment of hypertension include

diuretics, angiotensin-converting enzyme (ACE) inhibitors or
Figure 7: Ambulatory BP Monitoring angiotensin receptor blockers (ARBs), beta-blockers, and calcium
channel blockers (CCBs).
Lab Tests
Blood and urine tests are done to check for conditions that can Diuretics
cause or worsen high blood pressure. For example, tests are done Diuretics help rid your body of sodium and water. Most work by
to check your cholesterol and blood sugar levels. You may also making your kidneys release more sodium into the urine. The
have lab tests to check your kidney, liver and thyroid function [21]. sodium then takes water with it from your blood decreasing the
amount of fluid flowing through your blood vessels hence lowering
Electrocardiogram blood pressure. Diuretics are used effectively in the management
This quick and painless test measures the heart's electrical activity. of hypertension, and are typically prescribed because of their
It can tell how fast or how slow the heart is beating. During an efficacy, low cost, and low side effects profile. Diuretics are known
ECG, sensors called electrodes are attached to the chest and for their ability to increase the formation and excretion of urine.
sometimes to the arms or legs. Wires connect the sensors to a The increase in excretion allows for more water and sodium to be
machine, which prints or displays results [22]. removed, and ultimately affects the vascular system by leading to
a decrease in fluid volume. The decrease in fluid volume affects
Echocardiogram blood pressure directly, which is why they are effective in reducing
This noninvasive exam uses sound waves to create detailed images high blood pressure.
of the beating heart. It shows how blood moves through the heart
and heart valves [23]. Examples: Bumetanide , Furosemide, Torsemide etc [28].

Complications of Hypertension ACE Inhibitors

Hypertension, among other issues, can cause catastrophic heart Angiotensin-converting enzyme (ACE) inhibitors are medications
damage. Excessive pressure can harden arteries, reducing blood that help relax the veins and arteries to lower blood pressure.
and oxygen flow to the heart. This increased blood pressure and ACE inhibitors prevent an enzyme in the body from producing
decreased blood flow can result in: angiotensin II, a substance that narrows blood vessels. This

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Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

narrowing can cause high blood pressure and forces the heart Some calcium channel blockers can also slow the heart rate,
to work harder. Angiotensin II also releases hormones that raise which can further lower blood pressure. The medications may
blood pressure [28]. also be prescribed to relieve chest pain (angina) and control an
irregular heartbeat.
Examples of ACE inhibitors include
• Benazepril Calcium channel blockers are also called calcium antagonists.
• Captopril
• Enalapril Examples of calcium channel blockers include
• Eosinophil • Amlodipine
• Lisinopril • Diltiazem
• Moexipril • Felodipine
• Perindopril • Isradipine
• Quinapril • Nicardipine
• Ramipril • Nifedipine
• Nisoldipine
Angiotensin Receptor Blocker • Verapamil [30].
Angiotensin II receptor blockers help relax your veins and arteries
to lower your blood pressure and make it easier for your heart Combination Therapies and Personalized Treatment
to pump blood. Approaches
Hypertension is a key risk factor for atherosclerosis and ischemic
Angiotensin is a chemical in your body that narrows your blood heart disease that may be avoided. Despite the availability of
vessels. This narrowing can increase your blood pressure and contemporary and effective antihypertensive medications, most
force your heart to work harder. patients continue to have inadequate blood pressure management.
To reach therapeutic goals, most hypertension patients will require
Angiotensin II receptor blockers block the action of angiotensin a combination of antihypertensive medications.
II. As a result, the medication allows your veins and arteries to
widen (dilate). Most antihypertensive drugs combination whether fixed dosage
and free combination contain a diuretic. These combinations have
Examples of angiotensin II receptor blockers include been demonstrated to reduce blood pressure more effectively than
• Azilsartan mono-therapies. Combinations of a calcium antagonist and a renin-
• Candesartan angiotensin system inhibitor, whether an Angiotensin Converting
• Eprosartan Enzyme Inhibitor or an Angiotensin Receptor Blocker, have also
• Irbesartan been found to be useful and safe in the therapy of hypertensive
• Losartan patients [31].
• Olmesartan
• Telmisartan More personalized therapy options add the most benefit to patients
• Valsartan for whom straightforward, low-information-burden treatments are
ineffectual. The increased complexity of new information can be
Beta Blockers valuable if it enhances the possibility of excellent decision-making
Beta blockers also known as beta-adrenergic blocking agents, and improved results [11].
are medications that reduce blood pressure. Beta blockers work
by blocking the effects of the hormone epinephrine, also known Non-Pharmacological Interventions
as adrenaline. Non-pharmacological treatments are an important aspect of
hypertension care.
Beta blockers cause the heart to beat more slowly and with less • Device Based Therapies: Efforts to enhance blood pressure
force, which lowers blood pressure. regulation have expanded beyond traditional measures of
lifestyle modification and pharmacological therapy in the
Beta blockers also help widen veins and arteries to improve blood last decade to include interventional therapies. Based on
flow. animal and human research that clearly show a role for the
sympathetic nervous system in the etiology of hypertension,
Examples of beta blockers taken by mouth include recent technologies that have developed are mostly directed at
• Acebutolol neuro-modulation of peripheral nervous system targets. Renal
• Atenolol denervation, baro-reflex activation therapy, endovascular
• Bisoprolol baro-reflex amplification therapy, carotid body ablation,
• Metoprolol and pacemaker-mediated programmable hypertension
• Nebivolol management are examples of these treatments [32].
• Propranolol • Renal Denervation:With a recent series of proof-of-concept
trials demonstrating the safety and efficacy of radiofrequency
Calcium Channel Blockers and, more recently, ultrasound-based renal denervation, this
Calcium channel blockers are medications used to lower blood technology is poised to become available as a viable treatment
pressure. They work by preventing calcium from entering the cells option for hypertension in the near future [33].
of the heart and arteries. Calcium causes the heart and arteries to
squeeze (contract) more strongly. By blocking calcium, calcium
channel blockers allow blood vessels to relax and open.

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Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

Figure 9: Tele-Monitoring of Blood Pressure.

Figure 8: Device based therapies for HT. Emerging Trends and Future Directions
• Precision Medicine and Genetic Profiling: Personalized
Prevention and Management illness management that takes into account significant
Prevention encompasses a wide variety of actions known as patient characteristics allows for optimal therapy rather
"interventions" that try to reduce health risks or dangers. than management based on an average patient. Precision
hypertension management is critical since both susceptibility
• Early Detection and Screening Programs: Office to problems and responsiveness to therapy differ between
blood pressure measurement (OBPM) should be used people. While the use of genetic and proteomic personal
for first hypertension screening. A manual or automated traits for broad precision hypertension care is impractical,
sphygmomanometer is most typically used in the office other factors such as age, ethnicity, and cardiovascular
to assess blood pressure. Various OBPM procedures are disease have been included in hypertension management
available; however, in the studies examined by the OBPM recommendations. More blood-pressure-related clinical
was taken at the brachial artery (upper arm) after 5 minutes and physiological data in the patient's profile can be used in
of rest, with the patient most usually sitting and medical precision medicine to determine the hypertension threshold
professionals present during measurement. Before beginning and effective therapy. Several non-invasive and simple-to-use
therapy, ambulatory blood pressure monitoring (ABPM) and approaches for measuring hypertension-related physiological
home blood pressure monitoring (HBPM) with approved and parameters are proposed for use in hypertension precision
accurate equipment should be utilized outside of a clinical treatment [38].
context to confirm a diagnosis of hypertension [34].
• Public Health Strategies for Hypertension Prevention:
Lifestyle modification methods are used in combination
with antihypertensive drugs in the treatment of hypertension.
Weight control, the adoption of specialized food plans, dietary
salt reduction, physical exercise, and limitation of alcoholic
intake is the key lifestyle changes to lower and manage blood
pressure. Implementing and sticking to these techniques can
successfully and dramatically lower blood pressure levels,
as well as the risks of hypertension-related diseases in the
population [35].
• Patient Education and Self-Management Techniques:
Multiple studies have indicated that Hypertension Self-
Management (HSM), in which individuals measure their
blood pressure (BP) in nonclinical situations, is better
than typical office-based hypertension care. HSM leads to
more frequent blood pressure measurements, which allows
healthcare personnel to better determine the severity of a
patient's hypertension. Combining HSM with team care, in
which BP data from home monitoring is relayed to healthcare
practitioners on a frequent basis, resulting in even better BP
management [36].
• Telemedicine and Digital Health Solutions: Blood pressure
tele-monitoring (BPT) is a specialized use of telemedicine
for hypertension treatment that permits remote data transfer
of BP and associated information on patients' health status Figure 10: Precision Medicine.
from their home or community setting to the doctor's office
or the hospital [37]. • Novel Therapeutic Targets and Drug Development:
Hypertension is a common cardiovascular condition that
can occur on its own or as a result of other disorders. It is a
significant risk factor for coronary artery disease, myocardial
infarction, congestive heart failure, renal failure, and stroke.

J Cardiol Res Rev Rep, 2024 Volume 5(6): 6-8

Citation: Seema Thakur, Baljeet Singh, Neha Srivastava (2024) Hypertension: A Comprehensive Review. Journal of Cardiology Research Reviews & Reports.
SRC/JCRRR-224. DOI: [Link]/10.47363/JCRRR/2024(5)202

The results of novel approaches revealed various targets that

might be investigated as prospective treatment possibilities.
Toll-like receptor 4, which is a key regulator of angiotensin
II-induced hypertension; protease-activated receptor 2, which
promotes collagen deposition and inflammatory responses;
chemerin, which causes metabolic and obesity-related
hypertension; apelin receptor; transient receptor potential
melastatin; urotensin-II; and Tie2 receptor are among them
[39].
• Artificial Intelligence and Machine Learning Applications:
Hypertension is becoming more common as the world's
population ages, resulting in millions of premature deaths
each year. The biggest barriers to efficient hypertension care
are a lack of awareness of blood pressure (BP) increase and an
inadequate hypertension diagnosis. However, the emergence
of artificial intelligence (AI) illuminates new tactics for
hypertension care, such as remote telemedicine support and
big data-derived prediction. There is substantial evidence Figure 12: Wearable Devices for Hypertension.
that AI applications in hypertension control are feasible. A
foreseen trend was the integration of blood pressure measures Conclusion
with different wearable sensors and cellphones, allowing for This review paper provides a comprehensive analysis of
continuous and simple monitoring. In the meanwhile, more hypertension, covering various aspects such as etiology,
research is needed to verify the innovative prediction and pathophysiology, diagnosis, treatment, and prevention. By
prognostic techniques. Revolutionary breakthroughs have highlighting recent advancements and emerging trends, this paper
moved us closer to the future model [40]. aims to contribute to the existing knowledge base and facilitate the
development of effective strategies to combat the global burden
of hypertension. It emphasizes the significance of a holistic
approach encompassing lifestyle modifications, pharmacotherapy,
and targeted interventions for managing hypertension and its
associated complications.

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