Key takeaways

  • Essential hypertension, the most common type of high blood pressure, lacks a single identifiable cause but is associated with several modifiable and non-modifiable risk factors.
  • Often symptom-free, essential hypertension is diagnosed through blood pressure readings and managed via lifestyle changes like diet and exercise, and, if necessary, medications.
  • Untreated essential hypertension can lead to severe complications, including heart conditions and stroke, emphasizing the importance of regular monitoring and management.

There are two main types of hypertension (high blood pressure): essential (or primary) hypertension and secondary hypertension. Unlike essential hypertension, secondary hypertension has an identifiable cause, such as a kidney disorder.

Though there’s no known direct cause of essential hypertension, various factors can raise your risk of developing the condition. Treating hypertension usually means addressing those risk factors that you can change and taking medications if necessary.

Essential hypertension generally has no known cause, but there are a number of risk factors, some of which you can change. These are called “modifiable” risk factors.

Some people may also have a higher risk due to factors they can’t change, like genetics. Even though you can’t change these, knowing about them might help with strategies to prevent hypertension.

Some health conditions can also increase the risk of developing essential hypertension.

Modifiable risk factors

Some of the changeable risk factors for hypertension include:

  • low physical activity levels
  • a diet high in salt, added sugars, and saturated fats
  • high alcohol consumption
  • chronic or severe psychological stress
  • tobacco use
  • high cholesterol

Health conditions

Certain conditions may also raise your risk, including:

  • Overweight or obesity: Having overweight or obesity can raise your risk. Working with a healthcare professional or weight management program (if you have access to one) may help prevent hypertension.
  • Diabetes: Having diabetes can raise the risk of developing essential hypertension, and managing your blood sugar may help lower it.

Nonmodifiable risk factors

Some of the risk factors for hypertension can’t be changed or modified, such as:

  • Family history: Your hypertension risk increases if your parents or other close blood relatives have high blood pressure.
  • Age: Hypertension risk increases with age as the blood vessels become less elastic over time.
  • Sex assigned at birth: Males have a higher risk of hypertension up until age 64. After this age, females have a higher risk.
  • Race or ethnicity: Higher rates of hypertension exist among Black, Hispanic, and Asian people.

People with hypertension, no matter the cause, often don’t have symptoms. If the condition does cause symptoms, it’s usually because it has progressed and has led to complications.

Serious symptoms of unmanaged high blood pressure that require immediate medical attention include:

  • sudden, severe headache
  • breathing problems
  • sudden, severe pain in the back, abdomen, or chest
  • weakness or numbness
  • sudden vision changes
  • speech problems

Untreated hypertension can lead to serious health conditions, some of which may be life threatening. According to the American Heart Association (AHA), unmanaged high blood pressure might cause:

In addition to these, the National Heart, Lung, and Blood Institute (NHLBI) notes that unmanaged hypertension may lead to:

  • aneurysm, which refers to weakening and bulging of an artery wall
  • vascular dementia, which refers to damage in the brain that occurs due to reduced blood flow

Doctors diagnose hypertension based on blood pressure readings. A diagnosis typically requires high readings at two or more separate appointments.

When you first receive a diagnosis of hypertension, your doctor might not know right away whether you have essential (primary) or secondary hypertension. They might investigate further to find an underlying cause if your blood pressure is challenging to lower or you have other concerning symptoms.

Most people with high blood pressure have essential hypertension.

Blood pressure readings

Blood pressure readings measure two values: your systolic pressure (the pressure as your heart beats) and your diastolic blood pressure (the pressure between heartbeats). You’ll see these measurements as systolic pressure over diastolic pressure.

Healthcare professionals consider a systolic pressure of less than 120 over a diastolic pressure of less than 80 to be “normal” blood pressure. So if you have a blood pressure of 119 over 79 (or 119/79), you would be in the “normal” category.

If you have two or more separate readings of 130 to 139 over 80 to 89, you would have stage 1 hypertension.

Learn more about how to read a blood pressure chart and how to do a blood pressure reading at home.

Healthcare professionals typically recommend lifestyle changes and medications to manage high blood pressure.

Lifestyle changes

Lifestyle changes for managing high blood pressure typically involve addressing modifiable risk factors. Your doctor may recommend:

They may also recommend limiting the amount of salt, added sugars, and saturated fats you consume. A specific eating plan called the Dietary Approaches to Stop Hypertension (DASH) diet may be particularly helpful.

Your doctor or a registered dietitian can help you figure out the best eating plan for you.

Medications

Many medications are available to treat hypertension.

Each category works in a different way to bring down the pressure in blood vessels and, therefore, to bring down your systolic and diastolic readings. A doctor might prescribe one or more of these drugs.

Some common options are angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These medications help prevent blood vessel narrowing.

Calcium channel blockers help blood vessels relax by preventing the entry of calcium into the heart’s muscle cells. Diuretics remove excess water and salt from the body.

The following table lays out some examples of common medications in these categories:

Medication classMedication examples
ACE inhibitorsenalapril (Vasotec) and lisinopril (Zestril)
ARBslosartan (Cozaar) and valsartan (Diovan)
calcium channel blockersverapamil (Verelan) and amlodipine besylate (Norvasc)
diureticshydrochlorothiazide (Microzide) and eplerenone (Inspra)

These aren’t the only medications or drug classes that can treat hypertension. Your doctor can help you understand your options.

Essential hypertension is also called primary hypertension. It’s the most common type of hypertension and, unlike secondary hypertension, has no identifiable cause.

Treating hypertension typically means adopting a heart-healthy diet, increasing physical activity, and taking prescription medications. Your doctor can help you make a management plan that’s right for you.