ABSTRACT
Although hypertension has been recognized for centuries, the importance of its identification and treatment has been appreciated only during the past 150 years. Most commonly, hypertension is a silent process and is manifested only by sequelae of acceleration in the rate of atherogenesis and the frequency of cardiovascular morbidity and mortality rates. Uncommonly, the hypertension may be so severe that the elevated pressure itself produces vessel wall injury and the clinical picture of malignant hypertension. Although most physicians appreciate the potentially lethal nature of this malignant variety and the importance of its control, physician apathy toward the merits of aggressive diagnostic evaluation and management of asymptomatic patients with less severe hypertension continues to limit the impact of current knowledge on the populationwide success of treatment of this disorder.
