Essential hypertension is high blood pressure that doesn’t have a known secondary cause. It’s also referred to as primary hypertension.
Blood pressure is the force of blood against your artery walls as your heart pumps blood through your body. Hypertension occurs when the force of blood is stronger than it should be normally.
Most cases of high blood pressure are classified as essential hypertension. The other kind of hypertension is secondary hypertension. Secondary hypertension is high blood pressure that has an identifiable cause, such as kidney disease.
Genetic factors are thought to play a role in essential hypertension. The following factors may increase your risk of developing essential hypertension:
Most people won’t notice any symptoms of essential hypertension. They usually discover that their blood pressure is high during a regular medical checkup.
Essential hypertension can begin at any age. It most often occurs first during middle age.
Blood pressure checks are the best way to screen for the condition. It’s important to understand how to take your blood pressure and read the results.
Blood pressure readings have two numbers, usually written this way: 120/80. The first number is your systolic pressure. Systolic pressure measures the force of blood against your artery walls as your heart pumps blood to the rest of your body.
The second number measures your diastolic pressure. Diastolic pressure measures the force of your blood against your artery walls between heartbeats, as the heart muscle relaxes. Learn more about systolic and diastolic pressure.
Your blood pressure readings can fluctuate up or down throughout the day. They change after exercise, during rest, when you’re in pain, and even when you’re stressed out or angry. Occasional high blood pressure readings don’t necessarily mean you have hypertension. You won’t receive a diagnosis of hypertension unless you have high blood pressure readings at least two to three different times.
Normal blood pressure vs. abnormal blood pressure
Normal blood pressure is less than 120/80 millimeters of mercury (mmHg).
Elevated blood pressure is higher than normal blood pressure, but not quite high enough to be hypertension. Elevated blood pressure is:
- systolic pressure of 120 to 129 mmHg
- diastolic pressure less than 80 mmHg
Stage 1 hypertension is:
- systolic pressure of 130 to 139 mmHg, or
- diastolic pressure of 80 to 89 mmHg
Stage 2 hypertension is:
- systolic pressure higher than 140 mmHg, or
- diastolic pressure higher than 90 mmHg
Your doctor will test your blood pressure using a blood pressure monitor. If your blood pressure is high, they may want you to check your blood pressure at home during regular intervals. Your doctor will teach you how to use a blood pressure monitor if they ask you to measure your blood pressure at home.
You’ll record these readings and discuss them with your doctor at a later date. The severity of your high blood pressure is determined by the average of your blood pressure readings taken at different times.
Your doctor may perform a physical exam to check for signs of heart disease. This exam may include looking at your eyes and listening to your heart, lungs, and blood flow in your neck. Small blood vessels in the back of your eye can indicate damage from high blood pressure. Damage here indicates similar damage elsewhere.
Your doctor may also order the following tests to detect heart and kidney problems:
- Cholesterol test. Also called a lipid profile, this will test your blood for your cholesterol levels.
- Echocardiogram. This test uses sound waves to make a picture of your heart.
- Electrocardiogram (EKG or ECG). An EKG records the electrical activity of your heart.
- Kidney and other organ function tests. These can include blood tests, urine tests, or ultrasounds to check how your kidneys and other organs are functioning.
There’s no cure for essential hypertension, but there are treatments.
If you have elevated blood pressure or hypertension, your doctor will recommend lifestyle changes to lower your blood pressure. Lifestyle changes your doctor may recommend include the following:
- Exercise at least 30 minutes a day.
- Lose weight if you’re overweight.
- Quit smoking.
- Limit your alcohol intake to no more than one drink a day if you’re a woman and two drinks a day if you’re a man.
- Reduce your stress levels.
- Eat a low-sodium, heart-healthy diet that’s rich in potassium and fiber.
If you have kidney problems, don’t increase your potassium intake without your doctor’s permission.
If lifestyle changes don’t lower your blood pressure levels enough, your doctor may prescribe one or more antihypertensive medications. The most common blood pressure medications include:
- beta-blockers, such as metoprolol (Lopressor)
- calcium channel blockers, such as amlodipine (Norvasc)
- diuretics, such as hydrochlorothiazide/HCTZ (Microzide)
- angiotensin-converting enzyme (ACE) inhibitors, such as captopril (Capoten)
- angiotensin II receptor blockers (ARBs), such as losartan (Cozaar)
- renin inhibitors, such as aliskiren (Tekturna)
The higher your blood pressure is, the harder your heart has to work. A stronger force of blood can damage your organs, blood vessels, and heart muscle. This can eventually cause reduced blood flow through your body, leading to:
- heart failure
- heart attack
- atherosclerosis, or hardening of the arteries from cholesterol buildup (can lead to a heart attack)
- eye damage
- kidney damage
- nerve damage
You may need to try several different medications until you find a single medication or a combination of medications that effectively lower your blood pressure. You may need to continue your lifestyle changes or take your hypertensive medications for the rest of your life.
Some people are able to use medication to lower their blood pressure and then maintain that lower pressure with a healthier lifestyle, limiting their need for blood pressure medications.
With healthy lifestyle choices and medication, there’s a good chance that you can control your blood pressure. Controlling your blood pressure reduces your risk of heart attack, stroke, and heart failure. It also reduces the risk of damage to the eyes or kidneys. If you already have damage to your heart, eyes, or kidneys, treatment helps limit further damage.