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Labile hypertension: a faulty concept

M J Horan

    Comprehensive Therapy
    |November 1, 1982
    PubMed
    Summary

    Labile hypertension, now termed borderline hypertension, describes patients with blood pressure fluctuating around 140/90 mm Hg. These individuals exhibit no greater blood pressure lability than other groups.

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    Area of Science:

    • Cardiology
    • Hypertension Research
    • Clinical Medicine

    Background:

    • The term 'labile hypertension' historically described patients with blood pressure readings fluctuating above and below 140/90 mm Hg.
    • This concept lacked robust supporting data and likely arose from the propagation of a fixed threshold for hypertension.
    • Patients previously labeled as labile hypertensives do not demonstrate increased blood pressure variability compared to normotensive or fixed hypertensive individuals.

    Purpose of the Study:

    • To re-evaluate the concept of labile hypertension and its clinical relevance.
    • To clarify the appropriate terminology and diagnostic criteria for patients with fluctuating blood pressure readings.
    • To discuss the management strategies for patients with borderline blood pressure levels.

    Main Methods:

    • Review of existing literature and clinical concepts regarding labile hypertension.
    • Comparison of blood pressure variability in patients with labile hypertension versus normotensive and fixed hypertensive subjects.
    • Analysis of the characteristics and potential underlying abnormalities in borderline hypertensive patients.

    Main Results:

    • Evidence supporting the concept of labile hypertension as a distinct entity is lacking.
    • Patients previously classified as labile hypertensives are now appropriately termed 'borderline hypertensives'.
    • Borderline hypertensives have blood pressure readings falling between normotensive and hypertensive ranges, with no increased lability.

    Conclusions:

    • The term 'labile hypertension' is outdated and lacks scientific basis.
    • Borderline hypertension is the accurate classification for individuals with blood pressure fluctuating around the 140/90 mm Hg threshold.
    • Management of borderline hypertensives requires individualized conservative therapy, considering multiple factors including risk factors and end-organ damage.

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