More visits to a physician’s office are related to hypertension (HTN), or high blood pressure, than any other factor. More than 60 million cases of HTN have been diagnosed in the United States. This condition occurs when the force of blood exerted by the arterial blood vessel exceeds a blood pressure of 140/90 mm Hg. Ninety percent of HTN cases are classified as primary essential, or idiopathic, with no single known causative etiology. Another classification, secondary HTN, is caused by kidney disease or hormonal problems or induced by oral contraceptives, pregnancy, or other causes.

Another way of classifying hypertension is illustrated in the accompanying chart adapted from the National High Blood Pressure Education Program. This system uses systolic and diastolic blood pressure values to classify hypertension into stages according to severity. The guidelines that accompany this scheme emphasize the belief that there is no precise distinction between normal and abnormal values—thus even those in the high-normal range or the prehypertension range may be treated as having HTN.



Many risk factors have been identified in the development of HTN. Genetic factors play a large role. There is an increased susceptibility or predisposition with a family history of HTN. Men experience higher rates of HTN at an earlier age than women, and HTN in African-Americans far exceeds that of Caucasians in the United States. There is also a direct relationship between age and high blood pressure. This is because as age advances, the blood vessels become less compliant and there is a higher incidence of atherosclerotic plaque buildup. The hormone found in oral contraceptives can also cause HTN. Risk factors include high stress levels, obesity, calcium deficiencies, high levels of alcohol and caffeine intake, smoking, and lack of exercise.

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