Prehypertension can put you in danger zone

If you haven’t learned the term yet, make a note of it: prehypertension.

The description of elevated but not yet dangerously high blood pressure entered the medical lexicon last year. Three new studies published recently in The Archives of Internal Medicine indicate that prehypertension is widespread and worrisome.

“I’m not sure how much people have taken note of it,” said Dr. Kurt Greenlund, an epidemiologist at the national Centers for Disease Control in Atlanta.

“People think, ‘Well, my blood pressure is a little high, but it’s not hypertension,’ so they wait until it’s too late.”

Current guidelines define hypertension as blood pressure readings of 140/90 or greater. The condition, which gets more common as people age, is associated with heart disease, stroke, kidney disease and other problems.

Blood pressure of 120/80 or below is considered normal. But the area between those figures is now drawing more scrutiny.

Last year the National Heart, Lung and Blood Institute announced a new category called prehypertension and urged Americans with blood pressure between 120/80 and 140/90 to work at lowering their numbers.

The most common recommendations include maintaining a healthy weight, eating right, cutting down on salt and sodium, not smoking and getting more exercise.

“It’s probably more effective to prevent getting high blood pressure in the first place than lowering it once you have it,” Greenlund says.

In short, don’t wait until your blood pressure hits 140/90 to do something about it.

“There is no magic cutoff point that makes you safe,” says Dr. Gerald Bulloch, a cardiologist at Methodist Dallas Medical Center. “People with hypertension don’t live as long or as well, because it contributes to other diseases.

“But prehypertension is not innocuous, and the risks get higher as the numbers go up.”

Giving the condition a name, as was done last year, “is a hook to help focus attention,” Bulloch says. “It has been underemphasized in the past. If you talked to the average patient before, they think they’re OK if they’re under 140.”

Dr. Shawna Nesbitt, medical director of the hypertension clinic at Parkland Memorial Hospital in Dallas, says the new definition has begun to have an effect.

“People have called me and said, ‘Oh, my goodness, what should I be doing?’.” says Nesbitt, who is also an assistant professor at the University of Texas Southwestern Medical School at Dallas. “It’s important to make people start thinking about the risk of developing high blood pressure.”

The first step, she says, is to check your blood pressure more frequently. Then it gets harder.

“The second step is to actually get people to change their lifestyles,” Nesbitt says.

She is also studying another option: medication. Physicians now prescribe drugs to lower blood pressure for people with hypertension, not prehypertension – unless there are other risk factors such as diabetes or arteriosclerosis.

Nesbitt is national coordinator of a clinical trial treating people with prehypertension with medication to see whether it helps prevent them from developing hypertension. Results are expected in June.

In the meantime, she says, her advice is simple and direct:

“Lose the weight and decrease the salt,” she says.