Essential (primary) hypertension occurs when you have abnormally high blood pressure that’s not the result of a medical condition. This form of high blood pressure is often due to obesity, family history and an unhealthy diet. The condition is reversible with medications and lifestyle changes.
Primary (essential) hypertension is high blood pressure that is multi-factorial and doesn’t have one distinct cause. It’s also known as idiopathic or essential hypertension. Above-normal blood pressure is typically anything over 120/80 mmHg. This means that the pressure inside your arteries is higher than it should be.
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Essential hypertension (now known as primary hypertension) damages your blood vessels. The condition worsens over time and can cause life-changing complications that include:
Unhealthy habits and certain circumstances put you at risk for essential primary hypertension.
Other types of hypertension have one distinct cause. These include a medical condition or side effects of medications. When there is a direct cause, it’s known as secondary hypertension. Primary and secondary hypertension can co-exist; particularly, when there’s an acute worsening of blood pressure, a new secondary cause should be considered.
Conditions that can cause secondary hypertension include:
In the early stages, primary hypertension has no symptoms. Over time, blood vessel damage can start affecting your health.
You may experience:
A diagnosis of primary hypertension is made when you have high blood pressure, but none of the conditions that cause secondary hypertension. The best way to know if you have it is by seeing a healthcare provider who will:
Healthcare providers use a device with an inflatable arm cuff and dial. They inflate the cuff and watch the dial while listening to the force of blood through a stethoscope.
The test results in two readings:
Normal blood pressure is below 120/80 mmHg. If either number is higher, you may have hypertension. Your healthcare provider will take multiple readings at different time points before determining the next steps in your care.
If there are multiple high blood pressure readings, your healthcare provider may recommend 24-hour ambulatory blood pressure monitoring. This test regularly measures blood pressure over 24 hours, even while you sleep. Healthcare providers take the average of these readings to confirm or rule out a diagnosis of hypertension.
Primary hypertension treatment typically includes lifestyle changes and medications.
Maintaining a healthy lifestyle includes:
Various medications can lower your blood pressure, including:
To prevent high blood pressure from worsening you can:
Many people lower their blood pressure with medications and lifestyle changes. Some people come off blood pressure medications after maintaining a healthy lifestyle. A small number of people experience no change in blood pressure despite trying several medications (resistant hypertension).
Medications alone are not enough to lower your blood pressure. For the best results, you need to live a healthy lifestyle.
It can be challenging to change what you eat and break old habits. Some people benefit from the help of health coaches, therapists or trusted friends. Setting realistic goals can help you make steady progress and feel your best.
A note from Cleveland Clinic
Essential hypertension is high blood pressure that is not due to another medical condition. There can be many causes, including obesity, family history and an unhealthy diet. Even though the condition does not cause symptoms, it’s critical to manage it. Essential hypertension can lead to blood vessel damage, putting you at risk for life-threatening complications. With successful treatment, you can lower your blood pressure and preserve your health for years to come.
Last reviewed by a Cleveland Clinic medical professional on 10/26/2021.
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