Prehypertension and hypertension (HTN) are highly prevalent risk factors for cardiovascular diseases worldwide. Robust epidemiological, mechanistic, and original prospective data establish hypertension-based chronic disease (HBCD) as a key driver of cardiometabolic-based chronic disease (CMBCD), extending beyond conventional frameworks that are limited just to HTN. The four stages of HBCD are risk, prehypertension, hypertension, and complications. Implementing stage-specific management strategies in clinical practice comprising evidence-based lifestyle, pharmacological, and procedural interventions can reduce HBCD progression and also decrease the risk of death and HTN-related complications. Clinical trials investigating the full spectrum of preventive care in patients at early HBCD stages are crucial to reducing downstream clinical and economic burdens related to prehypertension and HTN.