Why Prehypertension Should Not Be Ignored?

High blood pressure, also known as hypertension, is a risk factor for heart disease, stroke, congestive heart failure, and kidney disease. As such, making sure one’s blood pressure falls within the desired level is paramount. High blood pressure usually do not cause any symptoms. That is why it is also called the silent killer. According to survey, two-third of people with high blood pressure do not have it under control.

Desired blood pressure level is less than 120/80 mmHg. The top number (systolic pressure) measures the force from the heart as it contracts and the bottom number (diastolic pressure) indicates the pressure in the arteries when the heart relaxes between contractions.

Once a person’s reading exceeds 140/90, he or she is having high blood pressure. The higher the blood pressure, the harder the heart has to work and more wear and tear on the blood vessels. When a person’s blood pressure readings fall between 120/80 and 139/89, he or she is considered to have prehypertension. The blood pressure category is determined by higher number either the systolic or diastolic measurement. For instance, if a person’s systolic number is 115 but the diastolic number is 85, then this person is said to have prehypertension. This also means that though this person does not have high blood pressure yet, he or she is more likely to develop it in the future.

A new study conducted by American researchers reported that even though young people who have blood pressure of below 140/90 but at the high end of the normal range were still have a higher risk of developing heart disease some years later. These people should start watching their diet, exercising, and even taking medicines. The study covered 2,479 young adults over 25 years and their finding were published June 9, 2015 in ‘Journal of The American College of Cardiology’.

The study found that participants with high diastolic readings were 70 percent more likely than those with the lowest reading, of getting a treatment-resistant form of heart failure where the heart muscle is unable to relax. Some patients in the study had high-normal blood pressure in their 20s and 30s, and by the time they were 45, they had the heart function of a 75-year-old. The study, therefore, suggested that blood pressure control in early young adulthood might be essential to prevent coronary heart disease.

It is possible to prevent hypertension and prehypertension. People with these conditions can lower their blood pressure by adopting healthy diet and regular physical activity. For people who are obese or overweight, they should seek ways to lose weight. Smokers should quit smoking and alcohol drinkers should limit to one drink per day. Reducing stress can be helpful, too. If all these lifestyle changes cannot lower blood pressure, then they should see their doctor who might prescribe medicines for them.

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.