A 64-year-old black man presents for a routine visit to establish care. He denies past medical problems, but has been told that his blood pressure was a little high. He has no complaints, takes no medications, tries to adhere to a healthy diet, and rarely exercises. He reports that over the previous 5 years he has gained 15 lb (6.8 kg). Review of systems is otherwise noncontributory. Physical exam is notable for obesity and blood pressure 172/86 mmHg. The remainder of the exam is unremarkable.
Essential hypertension is typically an asymptomatic disease state at its onset and time of diagnosis. It may be associated with headache or visual changes, but this is rare outside of hypertensive urgency/emergency situations.
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