Everything to Know About Essential Hypertension

Medically Reviewed By Cynthia Taylor Chavoustie, MPAS, PA-C
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Essential hypertension refers to high blood pressure with no other medical condition. It is also called primary hypertension or benign essential hypertension. Essential hypertension is the most common type of high blood pressure. It usually occurs over time.

If you have essential hypertension, you can take steps to lower your blood pressure. This guide explains the possible causes and risk factors of hypertension, what treatments can help to reduce hypertension, and more.

Essential hypertension definition

Essential hypertension is high blood pressure that does not occur due to a medical condition or medication. Hypertension refers to a systolic/diastolic blood pressure reading of ≥130/80 mm Hg.

What is essential hypertension?

Essential hypertension refers to high blood pressure that is not secondary to medication or a medical condition.

For a high blood pressure diagnosis, the systolic blood pressure is usually 130 mm Hg or greater, and the diastolic blood pressure is usually 80 mm Hg or greater. This means that the top and bottom numbers would read 130/80 mm Hg or higher.

Learn more about high blood pressure.

What causes essential hypertension?

Woman checking blood pressure at kitchen table
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Unlike secondary hypertension, essential hypertension does not occur due to a medical condition or as a side effect of mediation.

Essential hypertension usually occurs over time. This means that you are more likely to experience it later in life. However, one study found that essential hypertension can present in children as young as 3 years old.

Risk factors for essential hypertension include:

  • age, as blood vessels naturally thicken over time
  • race, as people of African American and Hispanic descent are more likely to develop hypertension
  • family history of high blood pressure
  • consuming a diet high in sodium
  • having sensitivity to salt, as around 50–60% of people with essential hypertension are sensitive to salt
  • drinking a lot of alcohol or coffee
  • not getting enough physical activity
  • not getting enough quality sleep

Contact your doctor if you have concerns about the risk factors of hypertension.

What are the symptoms of essential hypertension?

Essential hypertension is usually asymptomatic. This means you may not realize you have chronically uncontrolled high blood pressure.

In some cases, you may experience symptoms of health conditions that can occur as a result of high blood pressure, including:

Contact your doctor if you experience any of these symptoms. Also, having a medical professional check your blood pressure at least once a year is recommended.

You can find out about symptoms never to ignore if you have high blood pressure.

How is essential hypertension treated?

Treatments for essential hypertension may include lifestyle changes and medication.

Lifestyle changes

Lifestyle changes that may help to reduce essential hypertension include:

  • reducing your salt intake
  • consuming a diet rich in potassium
  • avoiding or reducing your intake of alcohol
  • making sure you get enough quality sleep
  • making sure you get enough regular exercise
  • quitting smoking if you smoke

These steps can also help you to prevent hypertension if you do not currently have high blood pressure.

Maintaining a moderate weight may also help you to manage your blood pressure. You can discover safe weight-loss exercises for people with high blood pressure.

Medication

If lifestyle changes alone do not help to lower your blood pressure, your doctor may recommend medication.

Medications that can help to lower essential hypertension include:

  • ACE inhibitors or ARBs, which can prevent blood vessels from becoming too narrow
  • calcium channel blockers, which help blood vessels to relax by preventing calcium from entering muscle cells
  • diuretics, which help to remove excess water and sodium from your body
  • beta-blockers, which help to slow down your heart rate

Your doctor will recommend medication that may be suitable for you. It is important to ask your doctor any questions you may have before beginning a prescription.

Learn more about drugs prescribed for high blood pressure.

You can also find out how to tell if your blood pressure medication is too strong.

When should I contact a doctor?

Contact your doctor if you have concerns about essential or secondary hypertension.

If you take your blood pressure at home, record your reading and then take another reading 5 minutes later. Contact your doctor if your blood pressure remains high.

You should also contact your doctor if you have not had a blood pressure reading in the last year.

Find out more about when to contact a doctor for high blood pressure.

Hypertensive crisis

Contact your doctor immediately if your blood pressure is 180/120 mm Hg or higher.

You may be experiencing a hypertensive emergency if you have the following symptoms:

If you have any of the symptoms above, do not wait for your blood pressure to come down. Seek immediate medical attention.

How is essential hypertension diagnosed?

Your doctor may diagnose hypertension during a routine checkup. You should also aim for a medical professional to check your blood pressure at least once a year.

Checking your blood pressure involves using a blood pressure monitor and cuff or a stethoscope. Your doctor will take your blood pressure reading, which is quick and straightforward.

Once your doctor reads your blood pressure, they can explain the numbers. If you have hypertension, they will recommend the steps you can take to naturally lower your blood pressure.

If your doctor suspects that you have secondary hypertension, they may also wish to carry out other tests to determine whether there is an underlying cause. They will be able to explain these tests to you at your appointment.

White coat hypertension

It is important that you relax as much as possible during your appointment. You might find that readings in the doctor’s office are higher than those you take home with a blood pressure monitor. This may be due to some people’s natural nervousness when visiting a doctor’s office. The name for this elevation is “white coat hypertension.”

It may also be useful to take along to your appointment any recordings of blood pressure readings you have taken at home. This can help your doctor compare them to the readings in the doctor’s office.

Learn more about white coat syndrome.

What are the complications of essential hypertension?

If you do not receive treatment for essential hypertension, or if treatment is not effective, you may experience complications.

Possible complications of essential hypertension include:

Contact your doctor if you have concerns about hypertension. They will be able to take your blood pressure and recommend steps to lower your blood pressure if necessary.

You can learn more about the complications of high blood pressure.

Can I prevent essential hypertension?

There are steps that you can take to reduce your risk of essential hypertension.

Tips that can help you to prevent essential hypertension include:

  • consuming a diet low in sodium or salt and rich in potassium
  • avoiding alcohol or reducing your intake
  • quitting smoking if you smoke
  • taking steps to manage stress
  • getting enough quality sleep
  • getting enough regular exercise

Monitoring your blood pressure at home with a home blood pressure monitor can also help you to stay on top of any changes in your blood pressure. You can also record your blood pressure readings to take to your doctor if you have concerns about hypertension. Learn about home blood pressure monitors.

What is an optimal blood pressure reading?

Hypertension refers to high blood pressure that is consistently 130/80 mm Hg or higher.

The first or top number is the systolic number. This refers to how much pressure your blood creates against the walls of your arteries when your heart beats.

The second or bottom number is the diastolic number. This refers to how much pressure your blood creates against the walls of your arteries when your heart is resting. The table below offers information about hypertension and optional blood pressure readings.

Systolic readingDiastolic reading
Hypertension130 mm Hg or higher90 mm Hg or higher
Elevated blood pressure120–129 mm HgLess than 80 mm Hg
Optimal blood pressureLess than 120 mm HgLess than 80 mm Hg

You can learn more about what blood pressure readings mean.

Learn more

Summary

Essential hypertension is high blood pressure not secondary to a medical condition or medication. It tends to occur naturally over time.

You can take steps to lower your blood pressure or reduce your risk of essential hypertension. Your doctor may recommend medication if lifestyle changes do not alter your blood pressure.

Contact your doctor if you have concerns about high blood pressure. They can take your blood pressure reading and advise on any steps you should take to lower your blood pressure when necessary.

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Medical Reviewer: Cynthia Taylor Chavoustie, MPAS, PA-C
Last Review Date: 2022 Jul 29
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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