Hypertension is very common and typically asymptomatic, causing end organ damage over years (in concert w/other cardiovascular dz risk factors)
Hypertensive emergency: acute increases in BP beyond a threshold and/or otherwise very high values (i.e. acute end organ dysfxn): headache (intra-cerebral edema), cardiac ischemia, CHF, AKI, visual impairment, etc.
Primary hypertension: obesity, family history, excessive sodium intake, age, lack of activity, smoking, diabetes
Secondary hypertension (consider if onset < 30, accelerated, other findings, or unexpectedly hard to control): OSA, meds/toxins (e.g. NSAIDs, ETOH), hyperaldosteronism, hypo or hyperthyroidism, CKD, hypercortisolism, renal artery stenosis, pheochromocytoma, growth hormone excess
Hypertensive emergency: Abrupt head ache, confusion (encephalopathy); SOB, chest pain, DOE (cardiac ischemia, CHF); Visual loss (retinal hemorrhage)