This chapter discusses the approach to a newly diagnosed hypertensive patient. Hypertension is a reversible risk factor for myocardial infarction (MI), stroke, heart failure, atrial fibrillation, aortic dissection and peripheral arterial disease. Different stages of BP are normal, prehypertension, stage 1 hypertension and stage 2 hypertension. Primary or essential hypertension refers to the group where no secondary cause of hypertension is detected. They have three distinct hemodynamic subtypes that vary with age. These are systolic hypertension in young adults, diastolic hypertension in middle age and isolated systolic hypertension in older adults. Hypertension can be evaluated by taking medical history and physical examination and routine laboratory tests. A 12-lead electrocardiogram should also be obtained. Signs and symptoms that suggest special causes of secondary hypertension are tabulated. General approach to patient and specific strategies and approach for patient in different age groups are described.