Tuesday, January 08, 2008

Prehypertension is pretrouble indeed

If I get tired of time spent counseling folks on prehypertension, prediabetes, and prerenal failure, I just need to review the research to remember that these conditions are definitely pretrouble. Shoot, I just need to look back through the years of chart notes in some of my patients' records to see how their health unfolded out of pre-this, that, and the other into the real, unhealthy deal.

The ladies of the Women's Health Initiative, who contributed valuable data to much more than just the hormone therapy controversy, proved that blood pressures between 120/80 to 139/89 (the definition of prehypertension) roughly double the trouble. Investigators found that 39% of participants fell into this blood pressure category. Over a decade of follow-up, their risk for cardiovascular disease fell midway between the risk for those women with normal blood pressure and the group with pressures of 140/90 and above. The ten-year incidence was 3.32% for normotensives, 7.11% for prehypertensives, and 14.16 for hypertensives.

So that's what happened to 120/80 as 'normal.' It's yesterday's news; we've lowered target blood pressure to less than or equal to 115/75. Cardiovascular risk rises in a smooth progression for values greater than that.


JeanMac said...

I'm going to have to find the way to work on my mine - it's 130. Got to get regular walks in someway - seeing our MD soon.As usual,thanks for the info.

Ruth said...

I find that many doctors are not taking these new guidelines seriously, especially as I see middle aged friends and family developing "pre-hypertension". I have dreadful white coat hypertension so take my BP regularly at home.

kenju said...

I participated in the WHI, through UNC.(Glad to be of service)

My husband also has white coat hypertension, as does your 2nd commenter. When he had a stroke in August, his pressure, when we went to the ER, was 245 over 117. The ER doc said he had never seen anyone with pressure that high.

Mauigirl said...

Mine has been hovering under the 120/80 mark since I'm on two medications. My husband can't get below 120 over 80 even on three medications. I've got us both on a diet, am hoping he'll lose weight to bring it down the rest of the way.

I've always wondered whether having "white coat hypertension" really means a person is at risk in stressful situations. After all, if your BP goes up when you go to the doctor, what happens when something really stressful is going on?