title: Patients with prehypertension - do we have enough evidence to treat them?
abstract: In 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure established a definition of a new category of BP levels called 'prehypertension' (preHT) that included individuals with a systolic BP of 120-139 mm Hg or a diastolic BP of 80-89 mm Hg. Patients with preHT were considered to be at increased risk for progression to hypertension and in individuals with BP in the range 130/80 to 139/89 mmHg the risk of developing hypertension was twice as high as in subjects with lower values. Still then there has been a large debate whether the introduction of preHT was based on evidence and as a consequence, it was fully justified. It has been suggested that the term prehypertension may in many subjects create anxiety and a need for unnecessary medical visits and examinations. This group of patients is also very heterogeneous and it has been pointed out that subdividing preHT group into individuals with normal BP and high normal BP would much better correspond to the continuum of BP risk for CV disease. Finally, despite some data suggesting the potential benefits of antihypertensive therapy in patients with preHT (high normal BP), there are still no hard evidences on the outcome reduction by giving antihypertensive drugs in these individuals.
authors.forename: Michalska
authors.initials: M
authors.lastname: Marta
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanchetti
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.forename: Jolanta
authors.initials: J
authors.lastname: Malyszko
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113; 90-549 Lodz, Poland. maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D015444:Exercise; D006801:Humans; D017410:Practice Guidelines as Topic; D058246:Prehypertension / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy* / Q000453:epidemiology; D012306:Risk; D061217:Weight Reduction Programs
chemical_list: D000959:Antihypertensive Agents