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Prehypertension

Topic Overview

What is prehypertension?

Prehypertension is blood pressure that is higher than normal but not high enough to be high blood pressure. It is a warning that your blood pressure is going up.

Blood pressure is a measure of how hard your blood pushes against the walls of your arteries. Blood pressure that is too high (also called hypertension) harms your blood vessels. This raises your risk of heart attack, stroke, kidney failure, and other health problems. But you can take steps to get your blood pressure back to normal.

Blood pressure is shown as two numbers, such as 120/80 (say "120 over 80"). The top number is the pressure when the heart pumps blood. It is called the systolic pressure. The bottom number is the pressure when the heart relaxes and fills with blood. It is called the diastolic pressure. Normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher. Prehypertension is between 120/80 and 140/90. Your blood pressure can be too high even if only one of the two numbers is high.

What makes blood pressure go up?

Experts don't know the exact cause of high blood pressure. But they agree that some things can make blood pressure go up. They include not getting enough exercise and being overweight. Eating foods that have too much sodium (salt) and drinking too much alcohol also can raise blood pressure.

What are the symptoms?

Blood pressure that is higher than normal does not cause symptoms. Most people feel fine. They find out they have higher-than-normal blood pressure during a routine exam or a doctor visit for another problem.

How is prehypertension diagnosed?

A simple test with a blood pressure cuff is all you need to find out your blood pressure. The doctor or nurse puts the cuff around your arm and pumps air into the cuff. The cuff squeezes your arm. The doctor or nurse takes your blood pressure while letting the air out of the cuff.

Your blood pressure may be measured at two or more separate times to make sure that it is higher than normal. This is because blood pressure goes up and down throughout the day. Also, some people have higher blood pressure when they are in a doctor's office, but they have normal blood pressure at other times. This is called white-coat hypertension. If you think you may have this, talk to your doctor about checking your blood pressure more often to see if you really have high blood pressure.

How is it treated?

Many people can lower their blood pressure with diet, exercise, and other lifestyle changes. If those steps don't lower your blood pressure enough, you can take medicine. But because you are treating your blood pressure before it gets too high, lifestyle changes may be all you need.

Here's what you can do to help get your blood pressure back to normal.

  • Do not smoke or use other tobacco products. If you do smoke, talk to your doctor about treatments that can help you quit.
  • Lose weight if you are overweight. Losing as little as 10 lb (4.5 kg) can help lower your blood pressure.
  • Eat a healthy diet. The DASH diet is an eating plan that can help lower your blood pressure. DASH stands for Dietary Approaches to Stop Hypertension. It focuses on eating foods that are high in calcium, potassium, and magnesium. The DASH diet includes lots of fruits and vegetables, as well as whole grains, fish, and poultry. Your doctor may suggest that you talk to a dietitian if you need help planning what to eat.
  • Cut back on salt. For good health, less is best. Most people shouldn't eat more than 2,300 milligrams (mg) of sodium a day. If you have diabetes or chronic kidney disease, if you are African-American, or if you are older than age 50, try to limit the amount of sodium you eat to less than 1,500 mg a day.1 Your doctor will tell you how much you can have. Do not add salt to your food. Limit processed and canned foods, such as soups, frozen meals, and packaged snacks.
  • Limit alcohol to 1 drink a day for women and no more than 2 drinks a day for men. If your blood pressure tends to go up when you have alcohol, your doctor may suggest that you do not drink any alcohol.
  • Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.

Other Places To Get Help

Organizations

American Heart Association (AHA)
7272 Greenville Avenue
Dallas, TX  75231
Phone: 1-800-AHA-USA1 (1-800-242-8721)
Web Address: www.heart.org
 

Visit the American Heart Association (AHA) website for information on physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your nearest local or state AHA group. The AHA provides brochures and information about support groups and community programs, including Mended Hearts, a nationwide organization whose members visit people with heart problems and provide information and support.


CardioSmart
Web Address: www.cardiosmart.org

References

Citations

  1. U.S. Department of Health and Human Services, U.S. Department of Agriculture (2010). Dietary Guidelines for Americans, 2010, 7th ed. Washington, DC: U.S. Government Printing Office. Also available online: http://health.gov/dietaryguidelines/2010.asp.

Other Works Consulted

  • Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5): S213–S256.
  • Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003). Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC Express (NIH Publication No. 03–5233). Bethesda, MD: U.S. Department of Health and Human Services.
  • U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.

Credits

By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
Robert A. Kloner, MD, PhD - Cardiology
Last Revised March 29, 2013

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