• Do You Have Prehypertension?

    Categories for Blood Pressure Levels in Adults

    Image for hypertension article If you believe you have low or normal blood pressure, you may be off the mark. You might have prehypertension. The information below will help you find out where you stand and what you can do to control your blood pressure if you have prehypertension.
    Category Systolic blood pressure (mmHg) Diastolic blood pressure (mmHg) Lifestyle changes advised Drugs usually recommended
    Normal Less than 120 Less than 80 Encouraged No
    Prehypertension 120-139 80-89 Yes No
    Stage 1 hypertension 140-159 90-99 Yes Yes
    Stage 2 hypertension 160 or more 100 or more Yes Yes
    Source: Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA. 2003;289:2560-2572.
    Hypertension , or high blood pressure, is diagnosed when a blood pressure reading of 140/90 mmHg (millimeters of mercury) or greater is noted. The level must be seen on at least two readings to be officially diagnosed. The upper number is the systolic pressure when your heart contracts. The lower number is the diastolic pressure when your heart relaxes.

    Prehypertension Risk

    Prehypertensive patients are more likely to develop full-blown hypertension. They are also more likely to develop associated health problems. Heart disease , stroke , kidney disease, and blindness are all associated with hypertension.
    Studies indicate that cardiovascular risk increases as blood pressure rises above 115/75 mmHg. In fact, your risk doubles with every 20 mmHg rise in systolic pressure or with every 10 mmHg rise in diastolic pressure.

    Who Should Get Screened?

    According to the National High Blood Pressure Education Program, everyone should have a blood pressure check at least once every two years. If your blood pressure is above normal (that is, higher than 120/80 mmHg), your doctor may recommend that you have it rechecked more often. People at increased risk for hypertension may also need more frequent readings. Risk factors include a family history of the condition, African American race, above-normal weight, or age greater than 50.

    Prehypertension Treatment

    Unlike hypertension, prehypertension treatment does not usually include drugs. The mainstay of therapy for prehypertension is lifestyle changes. These changes can help to slow or prevent progression to hypertension. The National High Blood Pressure Education Program recommends:
    • Lose excess weight.
    • Increase physical activity to at least 30 minutes most days of the week. First, get your doctor’s approval to make sure you are healthy enough for regular exercise.
    • Eat a healthy diet. Include food that is low in fat and cholesterol and rich in whole grains, fruits, and vegetables.
    • Reduce your daily salt intake.
    • Limit alcohol use. This means no more than two drinks a day for men or one for women.

    RESOURCES

    American Heart Association http://www.americanheart.org/

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca/home/index%5Fe.aspx

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com/

    References

    Categories for blood pressure levels in adults. Available at: http://www.nhlbi.nih.gov/hbp/detect/categ.htm. National Heart, Lung, and Blood Institute (NHLBI). National Institutes of Health (NIH). Accessed March 29, 2010.

    Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA . 2003;289:2560-2572.

    Effect of high blood pressure on your body. National Heart, Lung, and Blood Institute (NHLBI). National Institutes of Health website. Available at: http://www.nhlbi.nih.gov/hbp/hbp/effect/effect.htm. Accessed April 26, 2012.

    Kottke TE, Stroebel RJ, Hoffman RS. JNC 7—It’s more than high blood pressure. Editorial. JAMA . 2003;289:2573-2575.

    Mean systolic blood pressure (SBP). World Health Organization website. Available at: http://www.who.int/gho/ncd/risk%5Ffactors/blood%5Fpressure%5Fmean%5Ftext/en/index.html. Accessed April 26, 2012.

    Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet . 2002;360:1903-1913.

    State-specific trends in self-reported blood pressure screening and high blood pressure—United States, 1991-1999. Morbidity and Mortality Weekly Report.Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5121a2.htm. Published May 31, 2002. Accessed April 26, 2012.

    Treatment of high blood pressure. National Heart, Lung, and Blood Institute (NHLBI). National Institutes of Health website. Available at: http://www.nhlbi.nih.gov/hbp/treat/treat.htm. Accessed April 26, 2012.

    Vasan RS, Beiser A, Seshadri, S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men. JAMA . 2002;287:1003-1010.

    Who can develop high blood pressure? National Heart, Lung, and Blood Institute (NHLBI). National Institutes of Health (NIH). Available at: http://www.nhlbi.nih.gov/hbp/hbp/develop.htm . Accessed June 12, 2003.

    Why is high blood pressure important? National Heart, Lung, and Blood Institute (NHLBI). National Institutes of Health (NIH). Available at: http://www.nhlbi.nih.gov/hbp/hbp/serious.htm . Accessed June 12, 2003.

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