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Do You Have Prehypertension?

Categories for Blood Pressure Levels in Adults | Prehypertension Risk | Who Should Get Screened? | Prehypertension Treatment

Categories for Blood Pressure Levels in Adults

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.

American Heart Association

http://www.americanheart.org/

National Heart, Lung, and Blood Institute

http://www.nhlbi.nih.gov/

Canadian Cardiovascular Society

http://www.ccs.ca/home/index_e.aspx

Heart and Stroke Foundation of Canada

http://www.heartandstroke.com/

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_factors/blood_pressure_mean_text/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.

Last reviewed April 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.