High normal blood pressure and prehypertension: The debate continues

• Published in: Canadian journal of cardiology Vol. 23; no. 7; pp. 581 - 583
• Main Authors: Bolli, Peter, MD, Hemmelgarn, Brenda, MD PhD, Myers, Martin G., MD, McKay, Donald, PhD, Tremblay, Guy, MD, Tobe, Sheldon W., MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 15-05-2007; Pulsus Group Inc
• Subjects: Blood Pressure; Cardiovascular; Clinical practice guidelines; High normal blood pressure; Humans; Hypertension; Hypertension - physiopathology; Lifestyle therapy; Prehypertension; Reference Values; Hypertension; Prehypertension; Clinical practice guidelines; High normal blood pressure; Lifestyle therapy
• ISSN: 0828-282X; 1916-7075
• DOI: 10.1016/S0828-282X(07)70805-X

Subjects with high normal blood pressure are at high risk of developing hypertension. Thus, the criteria of the Canadian Hypertension Education Program for diagnosis of hypertension and recommendations for follow-up now recommend that patients with high normal blood pressure (130 mmHg to 139 mmHg systolic and/or 85 mmHg to 89 mmHg diastolic) be followed up annually for the development of hypertension. Clinical trial data from subjects with high normal blood pressure show that 40% over two years and 63% over four years developed hypertension (140/90 mmHg or higher). These data are consistent with observational data from the Framingham Heart Study, which found a similar risk. Besides annual follow-up, the Canadian Hypertension Education Program recommends lifestyle therapy for individuals with high normal blood pressure. Ongoing research will establish whether any further management is required.