Just the Essentials of Essential Hypertension

Written by Rose Kivi | Published on August 15, 2012
Medically Reviewed by George Krucik, MD

What Is Essential Hypertension?

Essential hypertension is high blood pressure that does not have a known cause.

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 too strong.

According to the State University of New York’s Upstate Medical University, approximately 95 percent of cases of high blood pressure are essential hypertension (SUNY). The other five percent of hypertension cases are called secondary hypertension. Secondary hypertension is high blood pressure that has an identifiable cause, such as kidney disease.

There is no cure for essential hypertension, but there are treatments.

Understanding Blood Pressure Readings

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 the blood is pumped out of your heart 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.

Your blood pressure readings may be temporarily higher or lower throughout the day. They change after exercise, after rest, when you are in pain, and when you are happy or sad. Occasional high blood pressure readings do not necessarily mean you have hypertension. A diagnosis of hypertension is not usually made unless your blood pressure readings are consistently high.

Normal blood pressure is less than 120/80 mmHg.

Prehypertension is higher than normal blood pressure, but not quite high enough to be classified as hypertension. Prehypertension is a systolic pressure of 120 to 139 mmHG or a diastolic pressure of 80 to 89 mmHG.

Stage-1 hypertension is a systolic pressure of 140 to 159 mmHG or a diastolic pressure of 90 to 99 mmHG.

Stage-2 hypertension is higher than 160/90 mmHG.

Understanding the Dangers of Hypertension

The higher your blood pressure is, the harder your heart has to work. A stronger force of blood can damage your arteries, blood vessels, and heart muscle. This can eventually cause reduced blood flow through your body, leading to:

  • atherosclerosis (hardening of the arteries from cholesterol buildup, which can lead to a heart attack)
  • stroke
  • heart attack
  • heart failure
  • eye damage
  • kidney damage

What Are the Symptoms of Essential Hypertension?

Most people do not have symptoms of essential hypertension and only 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 the middle-age years.

What Increases the Risks of Essential Hypertension?

Genetic factors may play a role in essential hypertension. Diet, stress, and being overweight may increase your risks of developing essential hypertension.

How Is Essential Hypertension Diagnosed?

Your doctor will test your blood pressure using a blood pressure monitor. If your blood pressure is high, your doctor may want you to check your blood pressure at home during regular intervals. Doing so will help determine if the high blood pressure reading is a common occurrence. Your doctor will teach you how to use a blood pressure monitor if he or she asks you to measure your blood pressure at home. You will record these readings and discuss them with your doctor at a later date.

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. 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:

  • a blood test to check your cholesterol levels
  • an echocardiogram test that uses sound waves to make a picture of your heart
  • an electrocardiogram test that records the electrical activity of your heart
  • blood test, urine test, or ultrasound to check your kidney function

How Is Essential Hypertension Treated?

If you have prehypertension or hypertension, your doctor will recommend that you start with lifestyle changes to lower your blood pressure. Lifestyle changes your doctor may recommend include:

  • exercising at least 30 minutes a day
  • eating a low-sodium, low-fat diet that is rich in potassium and fiber (do not increase your potassium intake without your doctor’s permission if you have kidney problems)
  • losing weight if you are overweight
  • quitting smoking
  • limiting your alcohol intake to no more than one drink a day if you are a woman and two drinks a day if you are a man
  • reducing your stress levels

If lifestyle changes do not lower your blood pressure levels enough, your doctor may prescribe you one or more antihypertensive medications . The most common blood pressure medications include:

  • beta blockers (Lopressor, Toprol XL, Corgard)
  • calcium channel blockers (Norvasc, Cardizem, Adalat)
  • angiotensin-converting enzyme (ACE) inhibitors (Capoten, Zestril, Altace)
  • angiotensin II receptor blockers (Cozaar, Benicar, Diovan)
  • renin inhibitors (Tekturna)

Long-Term Outlook

You may need to try several different medications until you find a single medicine or a combination of medications that effectively lower your blood pressure. You may need to continue your lifestyle changes and/or take your hypertensive medications for the rest of your life. Some patients are able to use the medication to lower their blood pressure and then maintain that lower pressure with a healthier lifestyle, never needing blood pressure medication again.

According to the National Institutes of Health, there is a good chance your blood pressure can be controlled and your risk of heart attack, stroke, heart failure, eye damage, and kidney damage can be severely reduced or prevented (NIH, 2012). If you already have damage to your heart, eyes, or kidneys, treatment may make the effects of the damage less severe.

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