About Prehypertension

An estimated 70 million American adults1,2 have prehypertension, a blood pressure (BP) classification adopted in 2003 by JNC7. Prehypertension describes a range of BP levels that had previously been categorized as normal or borderline: 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic.3

JNC6 Classification (1997) Blood Pressure (mm Hg) JNC7 Classification (2003)
Optimal <120/80 Normal
Normal 120-129/80-84 Prehypertension
Borderline 130-139/85-89
Source: Seventh Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension3

Prehypertension is not a disease category, and, in most cases, patients are not candidates for drug therapy. However, prehypertension does increase a patient’s risk for developing hypertension.3 Furthermore, risk factors for CVD are more common in patients with prehypertension than in normotensive individuals.1

To reduce BP, prevent or delay the onset of hypertension, and enhance antihypertensive drug efficacy, the JNC7 recommends lifestyle modifications that include weight loss, a healthy diet, limited alcohol intake, and aerobic exercise (30 minutes/day on most days). Individuals who also have diabetes or kidney disease should be considered for drug therapy if lifestyle modification alone fails to reduce their BP to ≤130/80 mm Hg.3

Healthy diets have been shown to reduce BP. The Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in fruits, vegetables, and low-fat dairy products, and low in dietary cholesterol and saturated and total fat, reduces BP by 8-14 mm Hg and is recommended by the JNC7.3, 10 A low-sodium (≤2400 mg/day) DASH diet can further reduce blood pressure by 2-8 mm Hg.3


References:

  1. 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;164:2113-2118.
  2. Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164:2126-2134.
  3. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. U.S. Department of Health and Human Services. 2004. Available at: http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm. Accessed February 1, 2007.