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A patient with high normal blood pressure--should we treat?

Danuta Czarnecka1, Grzegorz Bilo

  • 1I Cardiac Department, Jagiellonian University, Medical College, Ul. Kopernika 17, 31-501 Krakow, Poland. dczarnecka@interia.pl

Blood Pressure. Supplement
|January 25, 2006
PubMed

Insights

Individuals with blood pressure (BP) levels approaching 140/90 mmHg, termed "high normal" or "prehypertension," face increased cardiovascular risks. Lifestyle changes are recommended, and pharmacological treatment may benefit high-risk individuals.

Area of Science:

  • Cardiology
  • Public Health
  • Preventive Medicine

Background:

  • Current normal blood pressure (BP) is typically below 140/90 mmHg.
  • A linear relationship exists between BP levels and mortality risk, even below the 140/90 mmHg threshold.
  • A significant population segment exhibits BP levels within normal limits but approaching the 140/90 mmHg threshold.

Purpose of the Study:

  • To examine the implications of blood pressure levels within the "high normal" and "prehypertension" categories.
  • To review the association between these BP ranges and cardiovascular risk.
  • To assess the current evidence for interventions in individuals with high normal BP.

Main Methods:

  • Review of existing guidelines (ESH-ESC 2003, JNC7).
  • Analysis of evidence linking "high normal" BP (130/85-139/89 mmHg) and "prehypertension" (120/80-139/89 mmHg) to cardiovascular risk.
  • Evaluation of trial data on lifestyle changes and pharmacological interventions.

Main Results:

  • "High normal" BP and "prehypertension" affect a substantial portion of the general population.
  • Evidence suggests an adverse risk profile and increased cardiovascular event risk in individuals with "high normal" BP.
  • Some trials indicate potential benefits of pharmacological treatment for high-risk individuals in this BP category.

Conclusions:

  • Individuals with "high normal" or "prehypertension" BP warrant attention due to increased cardiovascular risk.
  • Lifestyle modifications are recommended for this population.
  • Further robust evidence is needed to confirm the benefits of therapeutic interventions in this group.

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