According to new U.S. guidelines as many as 45 million Americans, more than one-fifth of the adult population, have prehypertension, a newly-classified and risky precursor to chronic high blood pressure.
According to new U.S. guidelines as many as 45 million Americans, more than one-fifth of the adult population, have 'prehypertension', a newly-classified and risky precursor to chronic high blood pressure. Experts urged American adults and their doctors to monitor for the slight elevations in blood pressure that indicate the condition. Patients who show prehypertension can greatly reduce their risk of later developing heart disease, stroke and kidney disease by eating healthier, exercising to lose weight, and quitting smoking.The guidelines classify normal blood pressure in U.S. adults as a systolic pressure of less than 120 mm Hg, the top number in a blood-pressure reading, which reflects pressure when the heart is contracting and a diastolic pressure of less than 80 mm Hg, the bottom number, which reflects the heart at rest. The new category of prehypertension applies to patients with a systolic pressure of 120-139 mm Hg and a diastolic pressure of between 80 and 89 mm Hg. Previously, systolic pressure up to 139 mm Hg, along with a diastolic pressure up to 89 mm Hg, had been considered normal or 'high-normal'. Experts said that their conclusions arose from evidence in more than 30 studies put out since 1997, and not from any one trial. The new guidelines also put current stage II and stage II hypertension into a single, new stage II category encompassing patients with blood pressure above 160/100 mm Hg. They also recommend combinations of blood-pressure-lowering drugs, usually a diuretic paired with other drugs like ACE inhibitors, beta-blockers or calcium channel blockers.
Approximately one-fourth of the U.S. adult population is believed to have high blood pressure. Still, experts worry that too few Americans are treated or are even aware of their condition or risk. Unpublished federal survey data suggest that while 70 percent of U.S. adults are aware of their blood pressure levels, only 60 percent with hypertension are treated, and only 34 percent have their condition under control.The panelists said that they want the new prehypertension category to spur more doctors and patients to monitor and aggressively treat high blood pressure before it leads to higher heart attack risk and other health problems. Meanwhile, a federal report released estimates that one in four Americans are essentially inactive.
National Heart, Lung, and Blood Institute, May 2003
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