Hypertension is a major independent risk factor for the development of coronary artery disease, heart failure, stroke, and renal failure. Despite many experimental and clinical trials, no optimal strategy for the treatment of hypertension has been established. This editorial comment presents recent advances in the treatment of hypertension based on randomized clinical trials. This review also introduces the effects of alternative medicine and novel antihypertensives agents and covers some emerging concepts, such as vaccination, gene therapy, and individualized therapy, that will shape the approaches to treatment in the years to come. (Korean J Med 76:409-415, 2009)