About Prehypertension

What is PreHypertension?

Prehypertension was defined by the JNC VII report as systolic blood pressure: 120 to 139 mm Hg and diastolic blood pressure 85 to 89 mm Hg. The ESH/ISH guidelines define prehypertension as borderline blood pressure values and refer to them as high normal blood pressure values. Since blood pressure levels vary with every measurement, it is not always easy to diagnose it. It is clear that we are dealing not with a threshold phenomenon but with a continuum from normotension, prehypertension to hypertension. This transition is gradual and progresses with age and changing life habits.  It is accompanied by progressive increase of risk factor severity. The extent of additional risk, imposed by prehypertension depends upon clustering of cardiovascular risk factors and upon the presence of additional end organ damage in the cardiovascular system..

What are the symptoms of PreHypertension?

Prehypertension, like most cases of hypertension is asymptomatic. The diagnosis will be made only if blood pressure is measured. If prehypertension is diagnosed-follow-up and non-pharmacologic measures are recommended.

Who gets PreHypertension?

Most people will eventually join the “prehypertension club”. Since blood pressure rises with aging, most people will reach values that will introduce them into the “club”. Additional risk factors will have an effect like- life habits, physical activity, alcohol drinking, smoking, stress and weight excess. Those should be approached too before pharmacological treatment will be considered in specific subgroups of patients.

How is PreHypertension diagnosed?

The only way to diagnose prehypertension is to measure blood pressure. The condition is totally asymptomatic and painless. Specific high risk groups should be evaluated like subjects with family history of cardiovascular risk factors, history of end organ damage and cardiovascular events – those are at higher risk and should be evaluated.

What are the treatments for PreHypertension?

The most important approach to treat prehypertension is to think. Many patients will not necessitate medical treatment and in many- changing life habits will suffice. However, in patients with end organ damage, even if asymptomatic, or after an event like MI, stroke etc., treatment will be considered and in many cases started.

What kind of doctors treat PreHypertension?

Prehypertension is and should be treated by physicians from all disciplines. The major bulk of physicians that treat prehypertension are Family Physicians, but also Cardiologists, Nephrologists, Endocrinologists, Neurologists, Specialists in Internal Medicine and practically Physicians in all specialties. Since prehypertension is so prevalent (more prevalent that the number of patients with hypertension), physicians in all disciplines of medicine should be acquainted with the phenomenon and state of the art approach.