Prehypertension: A Warning of Things to Come?
Blood Pressure Readings
Both numbers in a blood pressure test are important, but systolic pressure gives the most accurate diagnosis of high blood pressure in people age 50 or older. Here's what those numbers mean:
Systolic Blood Pressure
This is the first, or top, number in a blood pressure reading. It measures the pressure of blood against the artery walls as the heart beats.
Diastolic Pressure
This is the second, or bottom, number in a blood pressure reading. It measures the pressure of blood against the artery walls between heartbeats, when the heart is filling with blood.
February 2005 — High blood pressure, or hypertension, affects 50 million Americans, and once it develops, it can last a lifetime. Are you at risk for it? The answer may be as close as your nearest blood pressure cuff.
Hypertension is a prolonged elevation in the force of blood against the artery walls. By making the heart work harder and damaging the arteries, high blood pressure can lead to heart attack and stroke — two of the leading causes of death among American adults — as well as vision loss and heart and kidney failure.
But you can prevent and control hypertension by learning about it and taking action.
"Hypertension - known as a silent killer — most of the time has no recognizable symptoms," says Howard Berlin, MD, cardiologist on the medical staff at Memorial Regional Hospital, Memorial Hospital West and Memorial Hospital Pembroke. "This means that unless you are checked regularly, you may develop elevated blood pressure. If recognized early, however, hypertension is a treatable disease."
Understanding Prehypertension
In May 2003, health officials revised the national classification system for blood pressure levels and created a new category called "prehypertension." This means that while you may not have high blood pressure now, you are likely to develop it in the future. It is estimated that 23 percent more Americans are in this new "at-risk" category.
Before May 2003, "normal" blood pressure was considered to be 120/80 or lower (see explanation of the numbers at right). Borderline high blood pressure fell in the range of 130-139/85-89. Now, anyone with a systolic reading of 120 or higher and a diastolic reading of 80 or higher is considered to have prehypertension.
"This new range presents an opportunity to begin lifestyle changes in diet and exercise that can help prevent the long-term wear and tear on the arteries from hypertension," says Dr. Berlin.
Studies have shown that there is a relationship between elevated blood pressure and future problems with heart attack and stroke. In addition, even people who have normal blood pressure at age 55 may have a 90 percent chance of developing hypertension as they get older - unless they take steps to prevent it. By lowering the normal range, health experts hope to promote earlier, more aggressive treatment of hypertension.
Early Treatment with Lifestyle Changes
The majority of people with prehypertension can control their blood pressure by adopting healthy lifestyle modifications, such as weight reduction, a low-salt diet, regular exercise, limited alcohol consumption and smoking cessation.
"Unfortunately, the majority of people in the United States suffering from hypertension don't even know it," says Dr. Berlin. "If we could screen and treat everyone with prehypertension, we would drastically reduce the number of heart attacks, strokes and kidney failure."
"For patients with hypertension, it often takes multiple medications to effectively control blood pressure elevation. Patients need to work closely with their physician to determine a regimen that is effective and affordable, with minimal side effects." Treating high blood pressure, whether with medication or lifestyle modifications, is usually a lifelong process.
If you are concerned about your risk for heart disease and would like a referral to one of our highly qualified physicians, call Memorial Physician Referral Service toll-free at (800) 944-DOCS.