Prehypertension as a Predictor of Hypertension

1. Prehypertension as a Predictor of Hypertension L. Michael Prisant, MD Cardiologist Professor of Medicine Director of Hypertension and Clinical Pharmacology Medical College of Georgia Augusta, Georgia

2. JNC 7 Blood Pressure Classification Based on the mean ≥2 measurements at each of ≥2 visits BP Classification SBP mm Hg DBP mm Hg Normal <120 and <80 Prehypertension120-139 or 80-89 Stage 1 Hypertension 140-159 or 90-99 Stage 2 Hypertension ≥160 or ≥100 When SBP and DBP fall into different categories, use the higher category. Chobanian AV, et al. Hypertension. 2003;42:1206-1252.

3. Risk of Progressing to Hypertension Framingham Heart Study4-year rates of hypertension (95% CI)* Age 35-64 years Age 65-94 years Baseline BP Category Optimum 5.3 (4.4-6.3) 16.0 (12.0-20.9) Normal 17.6 (15.2-20.3) 25.5 (20.4-31.4) High-normal 37.3 (33.3-41.5) 49.5 (42.6-56.4) N=9845. *Rates are per 100 and are adjusted for sex, age, body mass index, baseline examinations, and baseline systolic and diastolic BP. Vasan RS, et al. Lancet. 2001;358:1682-1686.

4. Prevalence of Prehypertension National Health and Nutrition Examination Survey N=3488 Ethnicity Age Gender Greenland KJ, et al. Arch Intern Med 2004;164:2113-2118.

5. Prehypertension Recommendations • Not a disease category • Identifies individuals at high risk of developing hypertension to intervene and prevent or delay the disease from developing • Prehypertensive individuals are not candidates for drug therapy on the basis of their BP alone • Advise patients on lifestyle modifications to reduce risk of developing hypertension • Individuals with prehypertension and diabetes or kidney disease should be considered candidates for appropriate drug therapy if a trial of lifestyle modifications fails to reduce their BP to 130/80 mm Hg or less Chobanian AV, et al. Hypertension. 2003;42:1206-1252