Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
Other factors that can contribute to hypertension include:
• age (blood pressure usually increases with age)
• excessive alcohol consumption
• lack of exercise
• sleep apnea
Symptoms and Complications
Hypertension can occasionally cause headaches, vision problems, dizziness, or shortness of breath, but most people with hypertension have no symptoms. This is why hypertension is referred to as the "silent killer." Hypertension is usually discovered at a regular medical checkup when a doctor or nurse takes a blood pressure reading.
Making the Diagnosis
If your blood pressure is above the normal range for up to 5 readings (taken at different visits), your doctor will likely diagnose you with high blood pressure. Sometimes the doctor may diagnose you after a fewer number of readings, depending on how high above normal your blood pressure is and if you have other medical conditions. Blood pressure tends to be at its highest during exercise, physical work, or stress, and lowest during sleep. Everyone can have a temporary increase in blood pressure at one time or another, which is why it's important to take multiple readings.
If blood pressure is high, a physician will also want to know if there are any other risk factors such as high cholesterol, diabetes, inactivity, obesity, smoking, or a family history of heart disease. The more risk factors someone has, the higher the chance of getting heart disease or a stroke.
A doctor might take an electrocardiogram (ECG) for a reading of the electric activity of the heart, or get blood samples to see if high blood pressure has caused any organ damage.