Should You Take Medicines If You Have Prehypertension?

A person’s blood pressure is measured by 2 readings, systolic (top reading) and diastolic (bottom reading). For instance, a person’s blood pressure is considered normal if the blood pressure readings stay below 120/80 mm Hg. When the readings are persistently at 140/90 mm Hg or higher, this person is said to have hypertension, or more commonly known as high blood pressure.

 

However, there is a group of people whose blood pressures are between 120/80 and 139/89 mm Hg. They are said to have prehypertension. In the United States, it is estimated that more than 50 million adults develop prehypertension. If these people do not monitor and manage their blood pressure properly, they are very likely to become victims of hypertension.

 

Most people with hypertension are not aware of their condition. But hypertension is a risk factor for a number of disorders including heart disease, stroke, kidney disease and peripheral arterial disease.

 

In a paper published online on December 8, 2011 in ‘Stroke’ (Journal of the American Heart Association), researchers from the Harrington-McLaughlin Heart and Vascular Institute in Cleveland, Ohio found that people with prehypertension had a lower risk of stroke when they took blood pressure-lowering medicines.

 

After examining data collected from 16 studies, researchers compared anti-hypertensive drugs against placebo in 70,664 people with average blood pressure within the pre-hypertensive range. They found that patients who took blood pressure-lowering medicines had a 22 percent lower risk of stroke, comparing to those taking a placebo.

 

While there was no significant reduction in the risk of heart attack, there was a trend toward lower cardiovascular death in patients who took blood pressure medicines as compared with those on placebo. 169 patients had to take the blood pressure-lowering medicines for an average of 4.3 years in order to prevent one stroke in the study population.

 

This clearly contradicted to the American Heart Association’s guidelines, which recommend lifestyle change instead of taking medications for people with prehypertension to lower their blood pressure. The suggested changes in lifestyle include weight loss, physical activity, a diet rich in fruit and vegetables and low in salt and fat, and keeping alcohol consumption moderate (no more than 2 drinks for men and no more than 1 drink for women per day).

 

Though the researchers did not insist that people with prehypertension should take medicines instead of carrying out lifestyle changes, they stressed that taking blood pressure medicines can somewhat complement the lifestyle changes, as shown in their findings. Nevertheless, they urged medical community to discuss extensively about the cost of long-term therapy and the risks of taking blood pressure medicines before changing the guidelines.