The management of arterial hypertension has experienced great changes during the past years, based on the knowledge of its pathophysiology, as well as the development of new antihypertensive drugs. Recent studies show the effect of the dysfunction of the endothelium in hypertension, sleep apnea and a higher prevalence of primary hyperaldosteronism. The Sixth report of the Joint Committee makes a new classification of this pathology, including a new concept of the stratification of risk for each stage of the disease, and according to it a new way of treatment. This fact marks a new and a more aggressive behaviour to treat the hypertense patient. With respect to the treatment, the emphasis has been on the non-pharmacological measures, and the development of new antihypertensive drugs of long action and high through/peek rate. Prevention continues to be an important goal and main challenge for the clinician, given the high morbidity and mortality rate caused by hypertension.