Hypertension remains the leading cause of morbidity and mortality worldwide and significantly impacts the risk of all major cardiovascular events, including stroke, sudden cardiac death, coronary heart disease, heart failure, abdominal aortic aneurysm, and peripheral vascular disease. Important advances in our understanding of its pathophysiology contributed to clarifying the complex origins of the disease, involving dysregulation of multiple homeostatic systems influencing not only blood pressure but also the progression of end-organ damage related to hypertension. Growing evidence suggests that the pathophysiology of hypertension results from complex interactions between environmental and genetic factors, resulting in different risks and age of onset of the disease within the general population. This chapter reviews the recent statistics of hypertension with a specific emphasis on its prevalence and temporal trends in Europe. Also, it provides a comprehensive overview of the mechanisms involved in the aetiopathogenesis of hypertension, highlighting their relative importance in different forms of hypertension.