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Being diagnosed with prehypertension has some advantages–it may save your life for one thing

In May 2003, nearly a quarter of all adult Americans suddenly went from being in the safety zone for blood pressure to being at an increased risk for cardiovascular disease and stroke. What caused the change? It wasn’t stress or rapid weight gain, although these are factors for elevating blood pressure; rather it was a change in the way the federal government designates high blood pressure. Those whose blood pressure previously fell within the higher end of the healthy range are now considered prehypertensive.

In the past, adults with a systolic (top number) reading between 120 and 139 or a diastolic (bottom number) between 80 and 89 were in the “high normal” range, according to Dr. Richard Re, vice president and director of research at Ochsner Health Systems. Re thinks the Joint National Committee on Protection, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7), the group that changed the diagnosis, decided on the new label because there was a demonstrable
increased risk for cardiovascular disease within the prehypertension range. Re admits there is a counter argument that states when you change the name, then you’re labeling people sick who aren’t. He thinks, however, thatthe committee members wanted to put more teeth into the diagnosis and there was enough compelling proof to do so.

“They began to see evidence that prehypertensive people tended to migrate into the hypertensive category, so they wanted to point out that the issue was not simple,” Re explains. “There was a risk below 140/90 and these people shouldn’t be ignored that have this intervening blood pressure.”

In fact, according to the JNC 7 report, the risk for cardiovascular disease–heart attack, stroke, and kidney failure–begins even lower than the prehypertension category. For every 20-point increase from 115 systolic (the pressure of blood inside arteries when the heart beats), or a 10-point increase from 75 diastolic (the pressure of blood inside arteries when the heart is between beats), the chance of cardiovascular disease doubles.

Alarmingly, the new category means that almost half of American adults, 23 percent with prehypertension, and 25 percent with hypertension, are in the danger zone for high blood pressure. There is a slightly higher percentage of men than women in both categories, which doesn’t surprise Re.

“Men are bigger, heavier, and have testosterone instead of estrogen (which experts believe affects blood pressure),” Re says. “All of these things combined make men more susceptible to cardiovascular disease.”

Dr. David Hutchinson, a cardiologist at West Jefferson Medical Center, agrees with Re that a slightly higher percentage of men are prehypertensive, but the bigger issue might be that men don’t address the situation sooner.

“Men would have more to gain by taking better care of themselves,” Hutchinson says, trying to put a positive spin on the problem. “They don’t getannual checkups as often as they should, and they tend to wait later in the disease process.”

No matter what your gender, prehypertension doesn’t have to be a life sentence. Medication isn’t usually necessary, and simple lifestyle changes are very effective in treating the condition.

“People are reluctant to start medication and that’s good since first-line treatment is salt restriction and exercise,” Hutchinson advises.

“Two grams of sodium is the recommended daily salt intake, and exercise should include 30 minutes of cardio or aerobic daily.”

Hutchinson says half of those with prehypertension can avoid having to take medication if they stick to their diet and exercise plan. He adds that prehypertensive patients should drink in moderation, two drinks per day, and “you can’t bank it.”

It’s not surprising that two of the biggest reasons for an overall rise in the average American’s blood pressure are weight gain and lack of exercise. Re says these factors and other detrimental behaviors are particularly prevalent in New Orleans.

“I don’t have any hard data, but I suspect cardiovascular risks in this area are high,” Re opines. “People [here] tend to be overweight, eat too much salt, smoke, and drink a lot.”

High blood pressure is often referred to as the silent killer because it has no early symptoms and most people aren’t aware they have it. Finding out is as easy as getting your blood pressure taken regularly. If you have prehypertension, the lifestyle changes might be a little difficult, but the possible return, as Re points out, is priceless.

“If you have low blood pressure, your chances of living a long time are much better than if you have high blood pressure.”