Summary: European and Polish guidelines on the management of hypertension clearly suggest gradual therapy for newly diagnosed arterial hypertension. It is recommended to begin treatment with a combination of two drugs: an angiotensin-converting enzyme inhibitor (ACE-I) or sartan (ARB) with a calcium antagonist or a thiazide-like diuretic. Subsequently, in the absence of an optimal therapeutic effect, combining the three drugs, preferably in one tablet, increases the chances of therapeutic success. Such a procedure is exceptionally clear and easy to implement, especially in subjects without significant comorbidities, representing a population of young and middle-aged people. However, the situation becomes more complicated when a patient with long-term hypertension comes to the clinic, after many attempts to optimize therapy, with numerous comorbidities, not all of which constitute typical complications of hypertension, and their therapy imposes modifications to the typical antihypertensive therapeutic regimen. Pharmacological optimization of the treatment of hypertension, which is then one of many, often not the most important disease, is a difficult task, but necessary in order to maximally improve the patientʼs prognosis. This paper briefly presents the practical aspects of the treatment of hypertension as a disease accompanying other important chronic disorders. The presented ten scenarios demonstrate the leading problem which patients encounter at different stages of their life accompanied by uncontrolled hypertension.