Review article

Arterial Hypertension: From Definition to Diagnosis

Patricia Batković

Abstract

Arterial hypertension is the leading and potentially reversible risk factor for cardiovascular morbidity and mortality in Croatia and the world. According to the latest data from the nationwide EH-UH 2 study, the prevalence of hypertension in the adult population of Croatia is 50.9%, indicating an increase compared to previous epidemiological data. In the context of cardio-renal-metabolic prevention, timely recognition, classification, and optimal treatment of hypertension according to the current guidelines is an imperative. The diagnosis of arterial hypertension is based on repeated, properly conducted blood pressure measurements in office and out-of-office settings. Home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) are particularly important in identifying white-coat hypertension and masked hypertension. Validated oscillometric devices, proper measurement technique, and appropriate cuff size are the foundation of accurate diagnosis of arterial hypertension. The assessment of total cardiovascular risk is individualized using the SCORE2/SCORE2-OP tools, and additional stratification is enabled by identifying hypertension-mediated organ damage (HMOD), including left ventricular hypertrophy, albuminuria, reduced eGFR, increased carotid intima-media thickness, and elevated arterial stiffness-pulse wave velocity (PWV). HMOD has diagnostic, prognostic, and therapeutic value and allows for a more precise evaluation of therapeutic response. In cases of suspected secondary hypertension—especially in younger subjects, with sudden worsening of control or therapy resistance—targeted diagnostic evaluation is recommended, focusing on endocrine, renovascular, and other causes. The diagnostic algorithm requires integration of medical history (anamnesis), physical examination, laboratory, and imaging diagnostics. Public health interventions and national screening programs play a significant role in the early detection of hypertension, as does the continuous education of healthcare professionals on proper monitoring, measurement, and interpretation of blood pressure values. A comprehensive and multidisciplinary approach is essential to reduce the burden of hypertension at the population level.

Keywords

arterial hypertension, cardio-renal-metabolic risk, prevalence, guidelines, target organ damage, home and ambulatory blood pressure measurement (HBPM and ABPM)

Hrčak ID:

338514

URI

https://hrcak.srce.hr/338514

Publication date:

27.10.2025.

Article data in other languages: croatian

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