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Prehypertension: What is the Current Status?
1MBBS (Mal), FRCP (Eng), FAFPM (Hon), University of Malaya, Kuala Lumpur, Malaysia.
Insights
Prehypertension signifies elevated cardiovascular disease (CVD) risk, often coexisting with other risk factors. Lifestyle changes are recommended to manage prehypertension and reduce CVD risk until further treatment evidence emerges.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) risk is continuous across blood pressure (BP) levels.
- Prehypertension, BP between optimal and hypertension, is linked to increased CVD risk.
- Prehypertension is highly prevalent and frequently associated with dyslipidemia, dysglycemia, and obesity.
Purpose of the Study:
- To manage prehypertension by lowering BP.
- To prevent the progression from prehypertension to hypertension.
- To prevent BP-related CVD mortality.
Main Methods:
- Recognizing prehypertension as a significant CVD risk factor.
- Observing associations between prehypertension and other CVD risk factors.
- Considering lifestyle modifications as a primary management strategy.
Main Results:
- Eighty-five percent of individuals with prehypertension have at least one additional CVD risk factor.
- A recent study indicated angiotensin receptor blockers may reduce hypertension development from prehypertension.
- The impact of prehypertension treatment on CVD outcomes remains largely unknown, except in high-risk groups.
Conclusions:
- Lifestyle changes are a sensible and cost-effective approach to manage prehypertension.
- Lowering BP through lifestyle modifications can reduce overall CVD risk.
- Further research is needed on treatment modalities for prehypertension and their impact on CVD outcomes.
Abstract:
Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/ obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.
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