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Prehypertension

Author
Norman M Kaplan, MD
Section Editor
George L Bakris, MD
Deputy Editor
John P Forman, MD, MSc

INTRODUCTION

Long-term follow-up of patients destined to develop primary hypertension (formerly called "essential" hypertension) demonstrates that blood pressure readings gradually increase over time. They may initially be normal, then prehypertensive (or high-normal), and then intermittently elevated; however, the readings may show considerable variability or lability [1].

DEFINITIONS

The seventh report of the Joint National Committee (JNC 7) published in 2003 originally proposed the following classification based upon the average of two or more properly measured readings at each of two or more visits after an initial screen [1]; these definitions were reaffirmed by the American and International Societies of Hypertension (ASH/ISH) [2]:

Normal blood pressure – systolic <120 mmHg and diastolic <80 mmHg

Prehypertension – systolic 120 to 139 mmHg or diastolic 80 to 89 mmHg

Prevalence — The prevalence of prehypertension among adults in the United States is approximately 37 percent [3].

        

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Literature review current through: Nov 2016. | This topic last updated: Fri Apr 01 00:00:00 GMT 2016.
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References
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  1. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560.
  2. Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens 2014; 32:3.
  3. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation 2011; 123:e18.
  4. Shen L, Ma H, Xiang MX, Wang JA. Meta-analysis of cohort studies of baseline prehypertension and risk of coronary heart disease. Am J Cardiol 2013; 112:266.
  5. Vasan RS, Larson MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 345:1291.
  6. Qureshi AI, Suri MF, Kirmani JF, et al. Is prehypertension a risk factor for cardiovascular diseases? Stroke 2005; 36:1859.
  7. Hsia J, Margolis KL, Eaton CB, et al. Prehypertension and cardiovascular disease risk in the Women's Health Initiative. Circulation 2007; 115:855.
  8. Greenlund KJ, Croft JB, Mensah GA. Prevalence of heart disease and stroke risk factors in persons with prehypertension in the United States, 1999-2000. Arch Intern Med 2004; 164:2113.
  9. Pletcher MJ, Bibbins-Domingo K, Lewis CE, et al. Prehypertension during young adulthood and coronary calcium later in life. Ann Intern Med 2008; 149:91.
  10. Zhang Y, Lee ET, Devereux RB, et al. Prehypertension, diabetes, and cardiovascular disease risk in a population-based sample: the Strong Heart Study. Hypertension 2006; 47:410.
  11. Vasan RS, Larson MG, Leip EP, et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001; 358:1682.
  12. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA 2002; 287:1003.
  13. Franklin SS, Pio JR, Wong ND, et al. Predictors of new-onset diastolic and systolic hypertension: the Framingham Heart Study. Circulation 2005; 111:1121.
  14. Parikh NI, Pencina MJ, Wang TJ, et al. A risk score for predicting near-term incidence of hypertension: the Framingham Heart Study. Ann Intern Med 2008; 148:102.
  15. Julius S, Nesbitt SD, Egan BM, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med 2006; 354:1685.
  16. Schunkert H. Pharmacotherapy for prehypertension--mission accomplished? N Engl J Med 2006; 354:1742.
  17. Course of blood pressure in mild hypertensives after withdrawal of long term antihypertensive treatment. Medical Research Council Working Party on Mild Hypertension. Br Med J (Clin Res Ed) 1986; 293:988.
  18. Sasamura H, Hayashi K, Ishiguro K, et al. Prevention and regression of hypertension: role of renal microvascular protection. Hypertens Res 2009; 32:658.
  19. Heijnen BF, Peutz-Kootstra CJ, Mullins JJ, et al. Transient renin-angiotensin system stimulation in an early stage of life causes sustained hypertension in rats. J Hypertens 2011; 29:2369.
  20. U.S. Preventive Services Task Force. Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2007; 147:783.