Most studies on essential hypertension have been performed in men. The aim of the present study was to describe psychosocial characteristics of 40-year-old women with never-treated essential hypertension. Psychosocial factors like childhood traumas, economy and education were studied, and psychological assessments of irritability, hostility, ‘John Henryism’ and type A behavior pattern carried out. Hypertensive premenopausal women (n = 29) were compared with healthy, age-matched, normotensive women (n = 18). Neither the women nor the examining physicians were aware of the subjects’ blood pressure status, and the setting, thus, was double-blind. All women were investigated in the same phase of the menstrual cycle, and in a random order. The hypertensives’ parents more often had hypertension than the normotensives’. The psychiatrist who conducted the interviews correctly classified the majority of subjects as either hypertensive or normotensive. Alexithymia and difficulties in coping with aggression were more prevalent among the hypertensives. Hypertensive and normotensive women did not differ in most of the psychosocial factors previously found to differ between hypertensive and normotensive men. Our data may imply that psychosocial as well as genetic factors may contribute differently to the etiology of essential hypertension in women than in men.