Hypertension is one of the most important factors in the impairment of arterial endothelial cell function. Endothelial cells have been recognized as “an organ” with many important functions, such as the production of vasodilator and growth inhibitory factors; participation in the response to vasoactive substances; involvement in the regulation of macromolecular substance permeability; and maintenance of the body’s antithrombotic and fibrinolytic functions. Increased vascular wall stress and shear as well as increased vasoactive substances such as norepinephrine and angiotensin II cause damage to the vascular endothelium early in the course of hypertension. Many other cardiovascular risk factors such as diabetes mellitus, hyperlipidemia, hyperinsulinemia, and smoking all damage endothelial cells to varying degrees, and impairment of arterial endothelial cell function is a common pathway by which various risk factors contribute to atherosclerosis. Elevated blood pressure is associated with sympathetic excitation and decreased insulin sensitivity. White coat hypertension may develop into true hypertension. Elevated blood pressure during the flat exercise test is a risk factor for the development of hypertension. Hypertension accelerates brain aging in men, and there is a significant association between hypertension and brain atrophy. Elevated blood pressure is associated with cerebral white matter lesions, which are related to the pathogenesis of dementia. Nocturnal hypertension and reduced nocturnal blood pressure drop in hypertensive patients are associated with the occurrence of asymptomatic ischemic brain injury in patients with lacunar stroke and with recurrent stroke. Among the blood pressure indicators in the elderly, pulse pressure is the best predictor of death. Systolic blood pressure >160 mmHg and diastolic blood pressure <70 mmHg have the highest mortality rates with a relative risk of 1.90. Elderly people with systolic blood pressure ≥160 mmHg should be treated with medication. Systolic and pulse pressure have replaced diastolic blood pressure as the main determinants of blood pressure status. The analysis showed that diastolic blood pressure remained the strongest predictor of cardiovascular event risk at age <50 years; systolic and diastolic blood pressure had equal predictive value for cardiovascular events at age <60 years; and systolic and pulse pressure were the most important predictors of cardiovascular mortality and complication rates at age ≥60 years. In this age group, increased pulse pressure is the most important factor in assessing risk, but it is almost always accompanied by systolic hypertension. It has been suggested that 24-h mean blood pressure and pulse pressure have different predictive values for cardiovascular and cerebrovascular events: for every 10 mmHg increase in 24-h pulse pressure, the risk of cardiovascular events increases by 35%; for every 10 mmHg increase in 24-h mean blood pressure, the risk of cerebrovascular events increases by 42%. Hypertension was a strong independent predictor of increased overall mortality in diet-treated type 2 diabetic patients, with a risk rate of 1.68, and a risk factor for increased stroke mortality in diet- or drug-treated type 2 diabetic patients, with a risk rate of 3.17. The relative risk ratios for the incidence of hypertension and nephropathy in non-diabetic patients, diet-treated type 2 diabetic patients, and drug-treated type 2 diabetic patients were The relative risk ratio (RRR) of renal lesions in non-diabetic, diet-treated type 2 diabetic, and medically treated type 2 diabetic patients was 1.9 for normotension, 3.1 for hypertension grade 1, 6.0 for hypertension grade 2, 11.2 for hypertension grade 3, and 22.1 for hypertension grade 4. AT1 receptor gene polymorphism was associated with hypertensive renal damage. Hypertension is a risk factor for cerebral hemorrhage, SAH and ischemic stroke (almost all subtypes), and increased systolic or diastolic blood pressure can increase the incidence of stroke. Effective antihypertensive therapy reduces the incidence of all types of stroke by 38% and stroke mortality by 58%. In China, for every 1000 cases of systolic hypertension treated in the elderly, there were 55 fewer deaths, 39 fewer strokes, or 59 fewer major cardiovascular events over 5 years. The RRR for stroke was 1.30 and 1.76 in undertreated or untreated patients, and the incidence of stroke was 3.1% in men and 4.1% in women, compared with patients with controlled blood pressure after treatment. In the Systolic Hypertension in the Elderly Study (SHEP), the RRR for stroke was 36% when systolic blood pressure below 160 mmHg was used as the treatment target. In the Heart Outcomes Prevention Evaluation (HOPE) trial, the risk of stroke was reduced by 32% over 5 years in the ramipril group compared with the placebo group. A pooled analysis of individual data analysis of antihypertensive intervention showed a 28% reduction in stroke recurrence in the active treatment group of patients with prior stroke or TIA compared with the control group. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) randomized more than 6,000 patients with a recent stroke or TIA to perindopril alone or in combination with indapamide, and the risk of recurrent stroke within 4 years in the combination group compared with the placebo group. The risk of recurrent stroke within 4 years was 43% lower in the combination group compared with the placebo group and was not associated with baseline blood pressure levels. Clinical trials have evaluated the efficacy of diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin (AT) II receptor antagonists, and other agents. Recent evidence suggests that diuretics should be used as first-line antihypertensives, but special treatment should be given for specific diseases, such as coronary artery disease, which is more likely to benefit from beta-blocker and ACEI therapy. Clearly, further reductions in current average blood pressure levels would have important public health implications. It is estimated that a reduction in systolic blood pressure of 9 mmHg or diastolic blood pressure of 5 mmHg in China would prevent 450,000 deaths from stroke each year.