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(Hypertension. 2009;54:954.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Does Prehypertension Represent an Increased Risk for Incident Hypertension and Adverse Cardiovascular Outcome?

From the Division of Preventive Medicine (S.P.G.), University of Alabama at Birmingham, Birmingham, Ala; Ralph H. Johnson Veterans’ Affairs Medical Center (J.N.B.), Medical University of South Carolina, Charleston, S.C.; Department of Medicine, Medical University of South Carolina (D.T.L.), Charleston, S.C.

Correspondence to Stephen P. Glasser, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Ave S MT 638, Birmingham, AL 35205. E-mail sglasser@uab.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Literature is accumulating that the presence of prehypertension (pre-HTN; defined as a blood pressure [BP] of 120 to 139 mm Hg systolic and/or 80 to 90 mm Hg diastolic) is associated with increased long-term risk. It remains controversial, however, as to whether prehypertensive BP alone or its association with its common risk factor accompaniments is important in determining ultimate risk. In the past, pre-HTN was called transient hypertension (HTN), borderline HTN, and high-normal BP. Although the terminology has changed, what is increasingly agreed on is that pre-HTN is frequently a precursor of HTN and is associated with an excess morbidity and mortality from cardiovascular disease (CVD). In the Framingham Heart Study, 50% of patients age 65 years with a BP of 130 to 139/85 to 89 mm Hg progressed to HTN within 4 years. In those same patients who had a BP of 120 to 129/80 to 84 mm Hg, 26% became hypertensive within 4 years.¹ As observed in the Framingham Heart Study, BPs of 130 to 139/85 to 89 mm Hg impose twice the risk of CV disease compared with those whose BPs are <120/80 mm Hg.² Perhaps if pre-HTN was eliminated, almost half of all heart attacks could be prevented. To emphasize the wide variation in risk among prehypertensives, Lee et al³ combined 3 cross-sectional studies conducted in Singapore (baseline years: 1982–1995), where 5830 subjects were grouped into normotensive, pre-HTN, or HTN cohorts. Follow-up (median: 12 years) was done by linkage to the National Death Register. Outcomes included . . . [Full Text of this Article]