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Norman M Kaplan, MD
Section Editor
George L Bakris, MD
Deputy Editors
Daniel J Sullivan, MD, MPH
John P Forman, MD, MSc


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].


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 28 percent [3].

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Literature review current through: Sep 2017. | This topic last updated: Apr 01, 2016.
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