How to Manage Prehypertension

Prehypertension is a new term that alerts people to the very real risk of developing chronic high blood pressure if they don't take timely steps to improve their lifestyle habits, according to the National Heart, Lung, and Blood Institute. Someone who ends up with full-blown high blood pressure may, in time, develop heart disease, stroke, kidney disease, blindness, or dementia, and may have to stay on prescription drugs for life.

"The whole purpose of using the term 'prehypertension' is to encourage people to do what they can to reduce their risk for cardiovascular disease and to avoid having to use blood pressure medications," says Daniel Jones, M.D., a hypertension expert in Jackson, Miss., and a spokes person for the American Heart Association (AHA). "Everyone needs to be aware of their blood pressure level, particularly those with a family history of high blood pressure."

The numbers to remember are 120 over 80—the blood pressure reading that until recently was considered to fall in a healthy range. That reading now should be seen as a yellow light, experts say. According to federal guidelines, those numbers signal the low end, or the beginning, of prehypertension. Prehypertension is diagnosed when either the top number or the bottom number is high.

Checking the pressure

When blood pressure is high, the heart works too hard and excessive pressure is exerted against the walls of the arteries. Without effective treatment, the forceful blood flow eventually can harm the arteries.

Dr. Jones advises everyone to have their blood pressure measured every year or two, and more often if they have abnormal readings. There's no way to know if your blood pressure is high unless you have it checked, since you can feel perfectly relaxed and healthy yet still have an elevated level. According to the AHA, one in three adults has high blood pressure and only 78 percent of this population are aware of their condition.

"Keep in mind that 120/80 is where prehypertension begins, and 140/90 is where hypertension begins," Dr. Jones says. "Thus, when your top [systolic] number is anywhere between 120 and 139, or the bottom [diastolic] number is between 80 and 89, your reading is in the prehypertension range." The systolic reading is key, Dr. Jones adds, particularly in people older than 50.

When the systolic pressure is 120 or higher, people need to focus on lifestyle choices to try to improve their blood pressure. Starting at 140, they also need to discuss the use of drugs with their doctors.

To prevent hypertension, people with prehypertension need to live a healthy lifestyle, Dr. Jones stresses.

Get your body moving

Regular vigorous walking has been shown to help lower blood pressure numbers. But, "any type of physical activity is beneficial," says Dr. Jones. "My advice to people is to choose something they enjoy. If they enjoy walking, then walking a couple of miles most days of the week is a great way to get exercise. If they detest walking, then vigorous yard work may be a good option."

Keep weight under control

The increase in high blood pressure in recent years is in large part because of Americans' getting heavier, Dr. Jones says. Burning calories through exercise and adopting healthy eating habits will help you to lose weight or maintain a healthy weight. Losing as few as 10 pounds can have a significant effect on blood pressure levels.

Follow a healthy diet

"We eat for enjoyment, and we have grown to enjoy foods that aren't best for our health," says Dr. Jones. "Unhealthy foods plus lack of exercise is a dangerous combination." But crash dieting is not the answer, he adds. He and other hypertension experts advocate the DASH (Dietary Approaches to Stop Hypertension) eating plan as a rational approach to healthy eating.

"DASH isn't just for those with unhealthy blood pressure levels—it's for everyone," says Dr. Jones. "It focuses on high intake of fresh fruits and vegetables, whole grains, and low-fat dairy products; and it limits sugary foods and beverages, saturated fat, cholesterol, and sodium."

Limit salt and sodium

Salt-sensitive people—those whose salt intake has a clear effect on their blood pressure readings—definitely need to limit the sodium in their diets. Still, says Dr. Jones, "we all can benefit from eating less salt and sodium. Eating less salt from an early age can be beneficial to cardiovascular health."

Limit alcohol

Women and men of lower body weight should limit their alcohol to one drink per day, and men and heavier women should have no more than two drinks a day, according to international blood pressure guidelines. These guidelines aren't a recommendation to drink alcohol, Dr. Jones notes; rather, they offer limits for people who choose to drink.

Don't smoke

Smoking cigarettes temporarily causes an increase in blood pressure. That's not nearly as important as the fact that smoking adds to the risk of developing heart disease and stroke.

"A key message is that individuals who have prehypertension should not wait until they develop high blood pressure to do something," Dr. Jones advises. "The purpose of this new category of prehypertension is to move people to action—and that action should be a healthy lifestyle."


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