Crew Health Advice: Hypertension Hypertension remains one of the most common and consequential non-communicable diseases detected in pre-employment medical examinations (PEMEs). It is a leading cause of medical unfitness decisions in the maritime industry, contributing significantly to both individual health risk and operational safety. Global Prevalence & Burden An estimated 1.4 billion adults aged 30–79 years worldwide currently live with hypertension (blood pressure ≥140/90 mmHg). This reflects a substantial rise from past decades and underscores a continuing global trend. Only about one in five (≈23–28 %) of those with hypertension have it effectively controlled. Two-thirds of people with hypertension live in low- and middle-income countries, including many African and Asian nations relevant to maritime crews. A large proportion of individuals with hypertension remain undiagnosed (≈44 %). Health Impact Hypertension is a major risk factor for: Heart disease and heart failure Stroke Chronic kidney disease Vascular dementia and other cognitive impairments The condition accelerates vascular damage silently over years, with many patients reporting no symptoms until serious complications arise. The economic toll of hypertension extends to healthcare delivery systems and society, with millions of annual deaths and large cumulative costs borne by health services worldwide — for example, projections suggest that cardiovascular diseases cost low- and middle-income countries trillions of US dollars between 2011 and 2025. Updated Description of Hypertension Hypertension is defined as a sustained elevation of blood pressure with a systolic reading ≥140 mmHg and/or diastolic reading ≥90 mmHg on repeated measurements. It may remain asymptomatic for years, making routine screening essential, particularly in occupational and maritime settings. As blood pressure remains uncontrolled over time, high pressure injures vessel walls, promoting atherosclerosis and compromising bloo