OBJECTIVE: To observe the characteristics of acupoint sensitization in patients with essential hypertension, analyze the mechanical pain threshold and tenderness threshold of each acupoint, and summarize the clinical characteristics of high-sensitivity acupoints. METHODS: This study employed a cross-sectional matched case-control design and enrolled a total of 448 volunteer participants, including 224 patients with hypertension and 224 healthy controls. The main outcome measures included measuring the mechanical pain threshold and tenderness threshold of 16 highly sensitive acupoints in both hypertensive subjects and healthy controls. The receiver operating characteristic curve method was used to evaluate the sensitivity of each acupoint. Additionally, the rules of mechanical pain threshold, tenderness threshold sensitization rate, and degree of sensitization of each acupoint in hypertension patients were summarized to identify the optimal highly sensitive acupoints related to hypertension. RESUITS: The mechanical pain threshold and tenderness threshold of hypertensive patients were significantly lower than those of healthy subjects, the difference was statistically significant (P < 0.001), indicating that the mechanical pain threshold and tenderness threshold of hypertensive patients at various points had a downward trend. Acupoints with high incidence of sensitization in hypertensive patients include Quchi (LI11), Taichong (LR3), Fenglong (ST40), Xingjian (LR2), Taixi (KI3) and Renying (ST9). CONCLUSION: This study successfully achieved the objective of exploring acupoint sensitization in patients with primary hypertension. Hypertensive patients exhibited significantly lower mechanical pain thresholds and pressure pain thresholds compared to healthy subjects. These findings provide clinical evidence for acupoint selection in acupuncture treatment for primary hypertension.