Overview
Primary hypertension is chronic elevation of blood pressure arising from a multifactorial interaction between genetics, environment, vascular physiology, and cardiometabolic factors.
Risk Factors
Important associations include obesity, diabetes, dyslipidemia, family history, high dietary sodium intake, inactivity, and increasing age.
Assessment
Diagnosis requires appropriate repeated blood pressure measurement and clinical assessment for target-organ involvement and secondary causes when indicated.
Blood pressure should be measured using an appropriately sized cuff and confirmed rather than relying on one isolated reading.
Management
Lifestyle modification is central, including weight management, physical activity, dietary improvement, and reduction of excess sodium intake.
Antihypertensive medication is used according to blood pressure severity, cardiovascular risk, and evidence of target-organ damage.
Clinical Pearls
Primary hypertension is a diagnosis made after considering the patient profile and asking whether there is a secondary cause worth looking for.
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