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Prehypertension: demographics, pathophysiology, and treatment
1State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14216, USA. jizzo@buffalo.edu
Current Hypertension Reports
|August 10, 2007
Summary
Prehypertension management focuses on weight control. Angiotensin receptor blockers (ARBs) can slow blood pressure increases in prehypertensive individuals, especially if weight control is insufficient.
Area of Science:
- Cardiology
- Hypertension Research
Background:
- Prehypertension, introduced in JNC 7 (2003), is a controversial classification.
- Age-related systolic blood pressure (BP) increase is influenced by prior BP levels and obesity.
- Obesity activates neurohumoral systems, exacerbating age-related BP rise.
Purpose of the Study:
- To evaluate management strategies for prehypertension.
- To assess the efficacy of angiotensin receptor blockade (ARB) in retarding age-related BP increases.
Main Methods:
- Review of JNC 7 recommendations for prehypertension.
- Analysis of findings from the Trial of Prevention of Hypertension.
- Consideration of associated risk conditions like prediabetes and hypercholesterolemia.
Main Results:
- Optimal weight control (diet, exercise) is the primary recommendation for prehypertension, particularly in the elderly.
- The Trial of Prevention of Hypertension showed ARB therapy retards age-related BP increases in prehypertensive patients.
- Early ARB use may be considered for men and women without childbearing potential if weight control fails.
Conclusions:
- Weight management remains central to prehypertension care.
- ARB therapy presents a viable option to mitigate age-related BP progression in prehypertension.
- Individualized treatment considering comorbidities is crucial for effective prehypertension management.
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