Hypertension is not a disease entity but a physical sign that may or may not indicate a pathological process. Pickering1 describes it as merely one end of the distribution curve of observed blood pressures. It is based on an arbitrary dividing line between what is normal and what is alleged to be abnormal. It has apparently occurred to few observers that, if no disease is found to account for the elevation of the blood pressure above a stated upper limit of normal, the patient may have no disease, or at least no disease in any way related to the blood pressure. Most definitions of essential hypertension conform to the rulings of the insurance companies, which set the upper limit of systolic pressure at 140 mm. Hg and of diastolic pressure at 90 mm. Hg, but some authors have dropped any reference to the systolic pressure from their definitions, and
ESSENTIAL HYPERTENSION. JAMA. 1956;160(8):673–674. doi:10.1001/jama.1956.02960430063013
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