The problems in diagnostic steps in the hypertensive patient can be grouped in 4 categories: the etiological evaluation concentrates recently especially on renovascular hypertension since. This disorder is getting more common with the ageing population and since diagnosis and treatment have been simplified; the detection of additional risk factors is important to guide individual drug selection; the detection of organ manifestations (e.g. LVH) may help in the therapeutic decision especially in borderline hypertensives; ambulatory blood pressure monitoring is becoming increasingly used despite the lack of standardized and generally accepted means to evaluate the recorded data.