What You Need to Know About Essential Hypertension

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
March 4, 2022

Blood pressure is one of the most important vital signs—that’s why someone checks it each time you visit your doctor’s office. High blood pressure, also known as hypertension, can increase your risk of serious medical conditions including cardiovascular disease, stroke, kidney failure, and even dementia.

Sometimes, medical conditions such as diabetes or pregnancy can result in hypertension. When your high blood pressure isn’t caused by another medical condition, your doctor may diagnose you with essential hypertension which is sometimes referred to as primary hypertension.

Essential hypertension can occur due to a number of causes, but certain risk factors—like an unhealthy diet, smoking, or being overweight—can contribute. The good news is, hypertension is treatable, especially if your health care provider notices it and treats you when it’s less severe. 

In this article, I’ll answer the question, “What is essential hypertension?” and explain symptoms and causes of essential hypertension. I’ll explain how essential hypertension is diagnosed and treated, along with the medical risks it can cause. Finally, I’ll explain when to see a doctor for essential hypertension. 

What is Essential Hypertension?

Blood pressure is the force of your blood pushing against the walls of your arteries. The more blood that pumps through your arteries and the narrower your arteries are, the higher your blood pressure is. 

High blood pressure, or hypertension, is when the pressure of your blood against your artery walls is too high. It’s normal for your blood pressure to rise and fall from time to time, but  long-term hypertension heightens your risk for cardiovascular disease and other serious medical conditions. 

There are two types of high blood pressure. Essential hypertension—also called primary hypertension—happens when a person’s high blood pressure increases gradually over the course of years, without a distinct medical cause.

Essential hypertension is the most common kind of high blood pressure, and it’s usually caused or worsened by lifestyle factors, such as an unhealthy diet, lack of exercise, chronic stress, smoking, or heavy drinking. Secondary hypertension, on the other hand, usually stems from another medical condition, such as pregnancy, diabetes, or kidney disease. 

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Symptoms of Essential Hypertension

Essential hypertension doesn’t always cause symptoms, so people can have high blood pressure and have no idea until they go to the doctor. As the condition progresses, symptoms may start to develop.

Patients with hypertension may experience: 

Causes of Essential Hypertension

Unlike secondary hypertension, essential hypertension is usually multifactorial, which means it has a number of causes.

Certain risk factors can make people more prone to essential hypertension, such as: 

Diagnosing Essential Hypertension

Healthcare providers diagnose hypertension through blood pressure readings. Your blood pressure is measured with two numbers.

Systolic blood pressure—the top number on your reading—measures the pressure in your arteries every time your heart squeezes. Diastolic blood pressure, the bottom number in the reading, measures the amount of pressure in your arteries when your heart relaxes between beats.

Hypertension is defined as a systolic pressure reading between 130 and 139 mm Hg or a diastolic pressure between 80-89 mm Hg. You may have essential hypertension if you have consistently elevated BP readings, but none of the medical conditions that contribute to secondary hypertension.

So if you have high blood pressure, your healthcare provider will likely want to evaluate you for  those conditions before diagnosing you with essential hypertension.

Treating Essential Hypertension

Essential hypertension can lead to some serious medical problems if left untreated, but fortunately, it’s often treatable once detected. Depending on how high your BP is, your healthcare provider may recommend lifestyle changes, prescription medication, or a combination of both. 

Lifestyle changes

Because essential hypertension often stems from unhealthy lifestyle factors, making some basic lifestyle changes can help reduce your blood pressure.

If you have essential hypertension, your medical provider may recommend you: 

  • Eat a more nutritious diet: Rather than eating processed and fast food, it’s best to eat heart-healthy foods such as fruits and vegetables, lean meats such as fish and poultry, low-fat dairy, and whole grains. 
  • Get more exercise: Regular exercise can boost your overall health and strengthen your heart, which can decrease your blood pressure. Aim to get the equivalent of at least 150 minutes (two hours and 30 minutes) per week of moderate-intensity physical activity, such as brisk walking. 
  • Maintain a healthy weight: Being overweight isn’t always an indicator of poor health, but if you have essential hypertension, your healthcare provider may recommend weight loss through exercise and a nutritious diet to reduce your blood pressure. 
  • Eat less salt: Because a diet high in salt can contribute to hypertension, try not to eat more than 1,500 mg of salt each day.
  • Quit smoking: Tobacco products and hypertension are closely linked, because tobacco causes plaque to build up in the arteries. If you smoke, talk to your medical provider about how to quit
  • Drink less alcohol: If you drink alcoholic beverages frequently, cutting back can help lower your blood pressure. 
  • Manage your stress: You may not be able to reduce your stress, but you can find healthy ways to cope with it. Try confiding in trusted loved ones, seeing a psychotherapist, or practicing mindfulness, meditation, or deep breathing if you’re experiencing persistent stress. 

Medication 

Prescription medication can also help manage high BP in hypertensive patients.

Common drugs used for essential hypertension are:

  • Diuretics, or water pills, lower blood pressure by helping your kidneys excrete sodium and water. Usually, diuretics are the first line of treatment for high blood pressure. Some classes of diuretics include thiazide, loop, and potassium-sparing diuretics. 
  • ACE inhibitors, or angiotensin-converting enzyme inhibitors, relax your vessels and block a chemical that can narrow them. Some types of ACE inhibitors are lisinopril (Prinivil and Zestril), benazepril (Lotensin), and captopril.
  • Angiotensin II receptor blockers, or ARBS, relax blood vessels by halting the action of the chemical that narrows your blood vessels. Common ARBs include candesartan (Atacand) and losartan (Cozaar).
  • Calcium channel blockers, relax the muscles of your blood vessels. Some types of calcium channel blockers are amlodipine (Norvasc) and diltiazem (Cardizem and Tiazac) help.

There are other medications a doctor might prescribe along with these drugs if they aren’t working to control your blood pressure. As with any medication, your medical provider will help you determine the one that’s most likely to help you.

Risks of Essential Hypertension

Almost everyone has a higher-than-normal blood pressure reading from time to time. But if your hypertension persists over time, it can cause your arteries to harden and thicken and increase your risk for having a heart attack or a stroke. 

Other risks of essential hypertension are: 

  • Heart failure
  • Stroke
  • Aneurysm 
  • Kidney failure 
  • Vision loss
  • Metabolic syndrome, which increases your risk of diabetes, heart disease, and stroke
  • Trouble with memory or understanding
  • Dementia 

In general, your risk for medical consequences is higher the higher your blood pressure is and the longer it is left unmanaged. 

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When to See a Doctor

Going to your primary care visits, where you should get blood pressure readings, is one way to prevent high blood pressure and the negative outcomes it can cause. It’s much easier to treat hypertension when it’s less severe. 

If you think you may be experiencing a hypertensive emergency, which occurs when your blood pressure reaches levels so high it can damage your organs, call 911 right away.

Symptoms of a hypertensive crisis include: 

  • Severe chest pain 
  • Severe headache
  • Confusion and blurred vision 
  • Nausea and/or vomiting 
  • Shortness of breath 
  • Anxiety
  • Seizures
  • Numbness or weakness
  • Slurred speech or facial droop

If you don’t have any symptoms but you experience a rise in blood pressure that’s concerning to you, then it’s also important to check in with your doctor. 

How K Health Can Help

K Health offers affordable and convenient access to highly qualified doctors to treat and manage high blood pressure, as long as you are not having a hypertensive crisis.

You can meet with your K Health doctor from the comfort of your own home via the K Health app, all while knowing that you’re getting individualized and expert care.

Frequently Asked Questions

Can hypertension be cured?
Hypertension is a serious but treatable condition, and it’s generally easier to treat when it’s less severe. If you have high blood pressure, your healthcare provider can recommend treatments that might help to lower it, such as lifestyle changes and prescription medication.
What is the difference between primary and secondary hypertension?
Primary hypertension, also called essential hypertension, stems from a number of factors rather than one, specific medical cause. Secondary hypertension usually comes on suddenly due to a known cause, such as diabetes, kidney disease, or pregnancy.
Can essential hypertension be fatal?
A few high blood pressure readings may not be cause for concern, but over time, too much pressure in your arteries can cause them to thicken. This is called atherosclerosis, and it can heighten your risk of potentially serious medical emergencies such as a heart attack or stroke. If you have high blood pressure, speak to your healthcare provider about the best treatment option for you.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).

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