Epidemiological data suggests that hypertension remains a major modifiable risk factor for cardiovascular disease in Western countries. The prevalence of the disease among adults in Slovenia aged 25–64 years is between 40–50% (CINDI, 2006). The early detection and severity of typical target organ damage and secondary diseases are key determinants of cardiovascular prognosis in patients suffering from arterial hypertension (Mancia et al., 2009). The classic manifestations of hypertensive target organ damage include: damage in the conduit arteries (atherosclerosis), kidney (nephrosclerosis) and heart (left ventricular hypertrophy, diastolic dysfunction, reduction of coronary reserve). The recommendations of medical societies specializing in hypertension do not base risk stratification solely on blood pressure (BP), but rather take into account concomitant cardiovascular diseases as well (Mancia et al., 2009). Early detection and adequate management of hypertensive target organ damage can slow or prevent damage, or even allow disease regression where organ damage is still at reversible stage. Therefore, the diagnosis of hypertensive target organ damage is of decisive importance. The purpose of this review is to summarize current and emerging approaches to the pathophysiology, early detection and treatment of hypertensive disease.