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 high normal blood pressure values. The new AHA/ACC hypertension guidelines further lowered the definition of normotension. This new category is a continuum from normotension and prehypertension to hypertension and is a risk factor for cardiovascular disease. The extent of the additional risk imposed by prehypertension depends mainly upon additional cardiovascular risk factors and presence of end organ damage to 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, sooner or later, most people will reach values that will introduce them into the “club”. Additional risk factors will have an effect like- way of life, 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. Diagnosis of PreHypertension is based upon blood pressure measurement data. Those will be taken at office, at home and using ABPM according to the guidelines and physician discretion.

What are the Treatments for PreHypertension?

The most important approach to treat prehypertension is awareness to the condition. Many patients will not need medical treatment and in many- changing lifestyle 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 are the Consequences of Prehypertension, Hypertension and the Cardiometabolic Syndrome?

All components of the cardiometabolic syndrome lead to end organ damage of vital organs. This causes Atherosclerosis, CAD, Heart Failure, Renal Failure and PVD.

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 than number of patients with hypertension), physicians in all disciplines of medicine should be aware to the condition, evaluate them and make therapeutic decisions.