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Prehypertension in Adults
Elevated Blood Pressure Levels
If you believe you have low or normal blood pressure, you may be off the mark. You might have prehypertension. Prehypertension occurs when you have elevated blood pressure, but not high enough to require medical treatment. When your blood pressure is elevated, the risk of developing hypertension increases dramatically.
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.
Having prehypertension is your cue to take action. It is important to take steps now to lower your blood pressure before medical treatment is necessary.
As mentioned before, people with prehypertension are more likely to develop full-blown hypertension. They are also more likely to develop associated health problems. Heart disease , stroke , kidney disease, and impaired vision 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 United States Preventive Services Task Force (USPSTF), everyone aged 18 years and older should be screened for hypertension. 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.
If getting to the doctor for regular blood pressure testing is difficult for you, consider buying a home monitor kit. Blood pressure monitors are available at most drug stores.
Unlike hypertension, prehypertension treatment does not usually include medications. 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.
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Categories for blood pressure levels in adults. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/hbp/detect/categ.htm. Accessed January 14, 2014.
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 January 14, 2014.
Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 6, 2014. Accessed January 14, 2014.
James PA, Oparil S, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2013. [Epub ahead of print.]
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 January 14, 2014.
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.
- Reviewer: Michael Woods, MD
- Review Date: 01/2014
- Update Date: 01/14/2014