There are two primary hypertension types. For 95 percent of people with high blood pressure, the cause of their hypertension is unknown — this is called essential, or primary, hypertension. When a cause can be found, the condition is called secondary hypertension.

  • Essential hypertension. This type of hypertension is diagnosed after a doctor notices that your blood pressure is high on three or more visits and eliminates all other causes of hypertension. Usually people with essential hypertension have no symptoms, but you may experience frequent headaches, tiredness, dizziness, or nose bleeds. Although the cause is unknown, researchers do know that obesity, smoking, alcohol, diet, and heredity all play a role in essential hypertension.
  • Secondary hypertension. The most common cause of secondary hypertension is an abnormality in the arteries supplying blood to the kidneys. Other causes include airway obstruction during sleep, diseases and tumors of the adrenal glands, hormone abnormalities, thyroid disease, and too much salt or alcohol in the diet. Drugs can cause secondary hypertension, including over-the-counter medications such as ibuprofen (Motrin, Advil, and others) and pseudoephedrine (Afrin, Sudafed, and others). The good news is that if the cause is found, hypertension can often be controlled.

Additional Hypertension Types: Isolated Systolic, Malignant, and Resistant


  • Isolated systolic hypertension. Blood pressure is recorded in two numbers: The upper, or first, number is the systolic pressure, which is the pressure exerted during the heartbeat; the lower, or second, number is the diastolic pressure, which is the pressure as the heart is resting between beats. Normal blood pressure is considered under 120/80. With isolated systolic hypertension, the systolic pressure rises above 140, while the lower number stays near the normal range, below 90. This type of hypertension is most common in people over the age of 65 and is caused by the loss of elasticity in the arteries. The systolic pressure is much more important than the diastolic pressure when it comes to the risk of cardiovascular disease for an older person.
  • Malignant hypertension. This hypertension type occurs in only about 1 percent of people with hypertension. It is more common in younger adults, African-American men, and women who have pregnancy toxemia. Malignant hypertension occurs when your blood pressure rises extremely quickly. If your diastolic pressure goes over 130, you may have malignant hypertension. This is a medical emergency and should be treated in a hospital. Symptoms include numbness in the arms and legs, blurred vision, confusion, chest pain, and headache.
  • Resistant hypertension. If your doctor has prescribed three different types of antihypertensive medications and your blood pressure is still too high, you may have resistant hypertension. Resistant hypertension may occur in 20 to 30 percent of high blood pressure cases. Resistant hypertension may have a genetic component and is more common in people who are older, obese, female, African American, or have an underlying illness, such as diabetes or kidney disease.

Descriptive Hypertension Terms

White coat hypertension and labile hypertension are terms that have been used interchangeably to describe hypertension types that come and go. These forms could indicate a higher risk for developing hypertension, or they could just be a normal response. The term "labile" means blood pressure that changes over time — a pretty common occurrence for almost everyone.

The term "white coat hypertension" comes from the well-studied phenomena that patients may have high blood pressure when taken at their doctor's office or a clinic but have normal blood pressure when taken at home. Studies show this type of high blood pressure may affect as many as 30 percent of the population. Because blood pressure can vary, the American Heart Association recommends that you have your blood pressure documented at least three different times to accurately diagnose hypertension. Another suggestion is to repeat high blood pressure readings after 5 to 10 minutes.

While high blood pressure affects about 73 million American adults, most hypertension is very treatable. See your doctor regularly and make sure you know what your blood pressure is — your doctor can then figure out which of the hypertension types you have.