Hypertension affects approximately 1.28 billion adults globally and is the single most important preventable cause of premature cardiovascular disease, stroke, and death worldwide. The blood pressure thresholds and treatment targets have been debated extensively, with notable differences between the ACC/AHA 2017 guidelines (≥130/80 mmHg defines Stage 1 hypertension) and the ESC/ESH 2023 guidelines (≥140/90 mmHg for treatment initiation in most patients). The ESC 2023 guidelines represent a major update incorporating the SPRINT (systolic target <120 mmHg) and STEP (elderly Chinese patients) trial data, along with substantial evidence on combination therapy, fixed-dose combinations (FDCs), and SGLT2 inhibitors in hypertensive patients with CKD or HF.