Etiological Classification-guided Individual Intervention in Primary Hypertension

Etiological Classification-guided Individual Intervention in Primary Hypertension: An All-comer Registry Study

Eligible participants will first undergo a 1-week home blood pressure diary and 24-hour ambulatory blood pressure assessment. After a confirmed diagnosis of hypertension, etiological subtyping will be performed. Based on the blood pressure evaluation results and etiological classification, the most appropriate antihypertensive medication will be selected. Simultaneously, a personalized lifestyle prescription will be provided according to the patient's individual circumstances. Following medication initiation, participants will continue to monitor their blood pressure through home diaries. Monthly evaluations will be conducted, and if blood pressure fails to reach the target value, medication adjustments will be made based on the blood pressure diary until target levels are achieved. This regimen will be maintained long-term.

Inclusion Criteria:

• Age 18-65 years.
• Diagnosed primary hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg).
• signed informed consent.

Exclusion Criteria:

• Secondary hypertension or arrhythmias affecting blood pressure accuracy (e.g., atrial fibrillation).
• Comorbidities such as diabetes, chronic kidney disease (eGFR < 30 mL/min/1.73m²), coronary artery disease, heart failure, or serious valvular heart disease.
• History of stroke or myocardial infarction.
• Pregnancy, breastfeeding, or planning to become pregnant.
• Life expectancy < 1 year.
• Participation in another clinical trial.