Abstract
BACKGROUND: Hypertension is a major chronic cardiovascular disorder and a leading contributor to cardiovascular, cerebrovascular, and renal morbidity worldwide. Its development is influenced by the interaction of metabolic abnormalities, environmental exposure, lifestyle factors, and genetic susceptibility, resulting in substantial heterogeneity across populations. MAIN FINDINGS: This review summarizes current evidence on the multidimensional mechanisms of hypertension, including vascular dysfunction, endocrine imbalance, and neural dysregulation, as well as recent advances in diagnosis such as ambulatory and home blood pressure monitoring. It also examines the role of Traditional Chinese Medicine (TCM) in hypertension management. Available experimental and clinical studies suggest that TCM interventions, including herbal formulas, acupuncture, and integrated TCM-Western medicine approaches, may contribute to blood pressure reduction, vascular protection, and improvement of inflammatory and metabolic status through multi-target effects. At the same time, the current evidence base remains limited by small sample sizes, methodological heterogeneity, and insufficient standardization. CONCLUSION: Hypertension management requires a more comprehensive and individualized approach that integrates advances in modern diagnostics, precision medicine, and digital health with more rigorous evaluation of TCM-based and integrative treatment strategies. Strengthening methodological quality and standardization will be essential for clarifying the clinical value of TCM in hypertension care.