Hypertension is an important public health problem in developing countries especially in adults, aged 40-55 years. Prospective cohort and case-control studies conducted in developed as well as developing countries have supported the findings that both systolic and diastolic blood pressure have significant relationships to coronary heart disease, stroke, congestive heart failure, impaired renal function and other mortality risk factors. Increased life expectancy, urbanization, development and affluence show a strong correlation with increased hypertension prevalence in urban and rural populations of India. These modifying factors operate with other risk factors of hypertension in different combinations in different parts of the world. Such socio-demographic and lifestyle factors need to be focused to bring down the hypertension epidemic that is currently sweeping India and other parts of South Asia. The nature of genetic involvement in the development of hypertension also requires more studies.