Prehypertension: What is the current status?

Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/ obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.