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Pre-hypertension: another 'pseudodisease'?

Pascal Meier1, Franz H Messerli, Andreas Baumbach

  • 1The Heart Hospital, University College London Hospitals UCLH, 16-18 Westmoreland Street, London W1T 7HA, UK. pascalmeier74@gmail.com.

BMC Medicine
|November 16, 2013
PubMed

Insights

Pre-hypertension, defined as blood pressure between 120-140/80-90 mmHg, is a significant marker for increased cardiovascular risk. This finding prompts re-evaluation of hypertension thresholds and diagnostic criteria.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Hypertension is a major cardiovascular risk factor, with diagnostic thresholds progressively lowered over time.
  • Defining the precise blood pressure level causing end-organ damage remains challenging.
  • Current trends label blood pressures from 120-140/80-90 mmHg as 'pre-hypertension'.

Purpose of the Study:

  • To evaluate the scientific justification for lowering hypertension thresholds.
  • To assess the cardiovascular risk associated with pre-hypertension.
  • To discuss the implications of redefining 'pre-hypertension' as 'hypertension'.

Main Methods:

  • Meta-analysis of existing studies on blood pressure and cardiovascular risk.
  • Review of current expert committee guidelines and scientific literature.
  • Analysis of data from Huang et al. published in BMC Medicine.

Main Results:

  • A meta-analysis indicates pre-hypertension (120-140/80-90 mmHg) is a significant marker of increased cardiovascular risk.
  • The study questions whether pre-hypertension is an independent risk factor or merely a marker.
  • Controversy exists regarding the benefits of treating pre-hypertension to reduce cardiovascular risk.

Conclusions:

  • Pre-hypertension signifies increased cardiovascular risk, necessitating careful interpretation of current hypertension guidelines.
  • Lowering the hypertension threshold to 120/80 mmHg could redefine a large 'healthy' population as patients.
  • Further research is needed to clarify the independent risk status of pre-hypertension and the efficacy of its treatment.

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