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Prehypertension: epidemiology, consequences and treatment
Eduardo Pimenta1, Suzanne Oparil
1Endocrine Hypertension Research Center and Clinical Center of Research Excellence in Cardiovascular Disease and Metabolic Disorders, University of Queensland School of Medicine, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Australia. e.pimenta@uq.edu.au
Nature Reviews. Nephrology
|November 18, 2009
Summary
Prehypertension, defined as blood pressure between 120/80 and 140/90 mmHg, indicates an elevated risk for cardiovascular disease and early death. Lifestyle changes are recommended for all patients, with medication for those with comorbidities.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Prehypertension, identified in 1939, links elevated blood pressure to increased morbidity and mortality.
- Individuals with blood pressure >120/80 mmHg and <140/90 mmHg face higher risks of hypertension and cardiovascular events.
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) classified prehypertension as a risk state.
Purpose of the Study:
- To define prehypertension and its associated cardiovascular risks.
- To outline management strategies for individuals with prehypertension.
- To highlight the importance of risk factor burden and organ damage in prehypertension.
Main Methods:
- Historical review of studies linking blood pressure to health outcomes.
- Analysis of risk factors including obesity, diabetes mellitus, dyslipidemia, and inflammatory markers.
- Assessment of organ damage indicators such as microalbuminuria and left ventricular hypertrophy.
Main Results:
- Prehypertension is associated with increased risk of developing hypertension and cardiovascular disease.
- Elevated blood pressure in prehypertension is often accompanied by other cardiovascular risk factors.
- Evidence of organ damage is frequently observed in individuals with prehypertension.
Conclusions:
- Nonpharmacological interventions, including weight loss and dietary changes, are crucial for managing prehypertension.
- Lifestyle modifications effectively reduce the risk of cardiovascular events in prehypertension.
- Pharmacological therapy may be necessary for prehypertension patients with specific comorbidities like diabetes or chronic kidney disease.
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