Changing concepts in hypertension management.

Hypertension is the most common modifiable risk factor for cardiovascular disease and death, and lowering blood pressure with anti-hypertensive drugs reduces target organ damage and prevents cardiovascular disease outcomes. The recent trials SPRINT and HOPE-3 will lead to changes in the way we manage hypertension and impact on clinical practice guidelines. These studies also demonstrate the shift toward automated blood pressure measurements. We have reviewed these studies and others to put them in context with the guidelines that have come before and to describe how they will impact on hypertension treatment thresholds and targets, the treatment of hypertension in the elderly, and changing approaches to the management of hypertension including resistant hypertension.