Hypertension and Blood Pressure

The Difference Between Primary and Secondary Hypertension

Last updated on October 20th, 2022 at 07:57 am

If you’re one of struggling with chronic high blood pressure or hypertension, you probably know the dangers this condition brings. Known as the “silent killer,” unmanaged hypertension causes damage to your heart and blood vessels, usually without symptoms.

But did you know there are different hypertension? Primary and secondary hypertension can both lead to serious medical conditions, like heart disease and stroke, but there are key differences between them. Take a moment to learn about the differences between primary and secondary hypertension and the treatment options available.

What is primary hypertension?

Primary Hypertension (Formerly Known as Essential Hypertension) 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 because of obesity, family history, and an unhealthy diet.

When people talk about chronic high blood pressure, they’re most often referring to primary hypertension. That’s because primary hypertension, also referred to as essential hypertension, accounts for about 95% of hypertension.

Primary hypertension does not have a single known cause, but certain risk factors increase your chances of developing the condition, including:

  • Smoking
  • Family history
  • Sedentary lifestyle
  • Being overweight or obese
  • Having a poor diet
  • Not managing stress

Since high blood pressure can develop for no identifiable reason, it’s important to have your blood pressure evaluated at least once each year. Early diagnosis facilitates early treatment, which can stop further damage to your blood vessels.

What is secondary hypertension?

Secondary high blood pressure (secondary hypertension) is high blood pressure that’s caused by another medical condition. It can be caused by conditions that affect the kidneys, arteries, heart, or endocrine system. Secondary hypertension can also occur during pregnancy.

Unlike primary hypertension, secondary hypertension develops because of an underlying medical condition or disease. Secondary hypertension is rare, affecting about only 5% of people with chronic high blood pressure.

While many underlying conditions can cause secondary hypertension, some of the more common include:

  • Kidney disease
  • Adrenal disease
  • Hyperparathyroidism
  • Thyroid disease
  • Tightening of the aorta
  • Obstructive sleep apnea

The side effects of some medications can also contribute to secondary hypertension, including birth control pills, nonsteroidal anti-inflammatory medications (such as ibuprofen and aspirin), stimulants, some antidepressants, decongestants, and diet pills.

Symptoms of primary and secondary hypertension

Both primary and secondary hypertension can occur without specific symptoms or signs. This is true even when your blood pressure reaches dangerously high numbers. But there may be some indications that your chronic high blood pressure is secondary hypertension. These include:

  • Blood pressure doesn’t respond to medication or stops responding to medication that previously worked
  • Blood pressure is extremely high
  • No family history of high blood pressure
  • Not overweight or obese
  • A sudden onset of hypertension before age 30 or after 55

If you have any of these signs of secondary hypertension, discuss them with your doctor and you may need more frequent blood pressure checks.

Treatment for primary and secondary hypertension

A treatment plan for your hypertension based on your medical history, current lifestyle, and type of blood pressure. For patients with secondary hypertension, it’s essential to treat or manage the underlying medical condition.

Many treatments for primary hypertension are also effective at controlling secondary hypertension. These include:

  • Making healthy lifestyle changes, such as improving your diet and incorporating regular exercise
  • Practicing stress management, such as breathing exercises, yoga, and meditation
  • Eliminating dangerous habits, such as smoking and consuming too much alcohol
  • Taking medications to relax your blood vessels and improve blood flow
  • Getting regular screenings to monitor your progress and make adjustments to your treatment plan as needed
What is the difference between hypertension and essential hypertension?

Hypertension occurs when the force of blood is stronger than it should be normally. Most cases of high blood pressure are classified as essential hypertension. The other kind of hypertension is secondary hypertension. Secondary hypertension is high blood pressure that has an identifiable cause, such as kidney disease.

What is the difference between hypertension 1 and 2?

Stage 1: systolic between 130-139 mm Hg or diastolic between 80-89 mm Hg.
Stage 2: systolic at least 140 mm Hg or diastolic at least 90 mm Hg.

What are the 4 stages of hypertension?

The four stages of hypertension are elevated blood pressure (considered to be prehypertension and at higher risk for developing high blood pressure), hypertension stage 1, hypertension stage 2, and hypertensive crisis.

What is the classification of hypertension?

Classification (mmHg)
Prehypertension: 120–139 or 80–89
Stage 1 Hypertension: 140–159 or 90–99
Stage 2 Hypertension: ≥160 or ≥100


High blood pressure that doesn’t have a known cause is called essential or primary hypertension. In contrast, secondary hypertension has a known cause.

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