What’s the difference between systemic, essential and secondary hypertension?

Our arteries are origins of potential disease and death. Most of arterial disease happens through sclerosis, or a hardening of the arteries. Previously we called this arteriocleoris, but that’s too general. So now, sclerosis is defined as either medial calcific sclerosis, hypertensive vascular disease or atherosclerosis.

Hypertensive vascular disease, in particular, is also called arteriosclerosis because it involves arteriole’s intima and media thickening as a result of cumulative amounts of plasma proteins,plus overproduction of basement membrane and extracellular matrix.

Systemic hypertension, or high blood pressure, is associated with hypertensive vascular disease and is a problem that is widespread. The term systemic distinguishes the condition from a local high blood pressure as in pulmonary (lung) or portal hypertension (hepatic portal system). The chief risk factors are genetics, race, older age, smoking, obesity and stress.

Essential hypertension does not usually have an identifiable cause, but is just a defect in mechanisms that control blood pressure. It may involve a defect in the kidney’s ability to excrete sodium, a defect in the arteriolar smooth muscle, or a defect causing exaggerated response of autonomic system.

Secondary hypertension results as a secondary aspect from a disorder such as kidney damage that causes elevated blood pressure.

The consequences of hypertension are both arteriolosclerosis (reduced arteriole’s lumen) and possible stroke or heart attack.


Nowak TJ, Hanfod AG. Pathophysiology: Concepts and applications for health care professionals, 3rd ed. 2004. New York, McGraw-Hill.

Published by David Despain, MS, CFS

David is a science and health writer living on Long Island, New York. He's written for a variety of publications including Scientific American, Outside Online, the American Society for Nutrition's (ASN) Nutrition Notes Daily, and Institute of Food Technologists' (IFT) Food Technology magazine and Live! blog. He's also covered new findings reported at scientific meetings including Experimental Biology, AAAS, AOCS, CASW, Sigma Xi, IFT, and others on his personal blog "Evolving Health." David is also an active member of organizations including the National Association of Science Writers (NASW), the American Association for the Advancement of Science (AAAS), the American Society for Nutrition, the Institute of Food Technologists, and the National Audubon Society. David has a master's degree in human nutrition from the University of Bridgeport, and a bachelor's degree in English from University of Illinois at Springfield. He also earned his Certified Food Scientist credential from the Institute of Food Technologists.

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