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Each time, he received the same response: He had “essential hypertension” — high blood pressure with no underlying cause.

The trick is to identify those few who have high blood pressure as a symptom of another problem from the many who have essential hypertension.

Examples of the latter include interventions for occlusive atherosclerotic disease; elective procedures on backs, shoulders and knees; pharmaceutical management of cognitive impairment situational affective disorders, type 2 diabetes and essential hypertension; and many screening protocols.

One out of three Americans have it, and for well over 90 percent of them, no cause will be found — a condition called essential hypertension.