Title:Patients with Prehypertension - Do we have Enough Evidence to Treat them?
Volume: 12
Issue: 4
Author(s): Michalska Marta, Alberto Zanchetti, Nathan D. Wong, Jolanta Malyszko, Jacek Rysz and Maciej Banach
Affiliation:
Keywords:
Blood pressure, cardiovascular risk, high normal blood pressure, hypertension, prehypertension, risk stratification.
Abstract: In 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment
of High Blood Pressure established a definition of a new category of BP levels called ‘prehypertension’ (preHT) that
included individuals with a systolic BP of 120–139 mm Hg or a diastolic BP of 80–89 mm Hg. Patients with preHT were
considered to be at increased risk for progression to hypertension and in individuals with BP in the range 130/80 to 139/89
mmHg the risk of developing hypertension was twice as high as in subjects with lower values. Still then there has been a
large debate whether the introduction of preHT was based on evidence and as a consequence, it was fully justified. It has
been suggested that the term prehypertension may in many subjects create anxiety and a need for unnecessary medical visits
and examinations. This group of patients is also very heterogeneous and it has been pointed out that subdividing preHT
group into individuals with normal BP and high normal BP would much better correspond to the continuum of BP risk for
CV disease. Finally, despite some data suggesting the potential benefits of antihypertensive therapy in patients with preHT
(high normal BP), there are still no hard evidences on the outcome reduction by giving antihypertensive drugs in these individuals.
