Journal of Preventive Cardiology
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Year: 2019 I  Volume: 7I  Issue:2I  Pages: 1162 –1197
 

Mildly Elevated Blood Pressure: What to do?

Dr. Arvind K. Pancholia, MD, FACC, FESC, FCSI, FISH, FIMSA, MAMS

Head of Department, Medicine & Preventive Cardiology, ArihantHospital Research Centre, 271 GumashtaNagar, Indore, Madhya Pradesh, India

 

Abstract

According to the American College of Cardiology/American Heart Association guideline, mildly elevated blood pressure (BP) is the systolic BP (SBP) of 120–129 mmHg and diastolic BP (DBP) of <80 mmHg, which is in fact stage 1 prehypertension (PHTN) according to the seventh report of the Joint National Committee (JNC 7). These values are also the same as the high-normal BP set by European Society of Cardiology (ESC) and European Society of Hypertension (ESH) hypertension guideline. Thus, mildly elevated BP is nothing but PHTN by JNC 7 and high-normal BP by ESC/ESH.

Mildly elevated BP = Prehypertension = High-normal BP

Mildly elevated BP = Prehypertension = High-normal BP PHTN is a global health problem that increases the risk of developing hypertension as well as cardiovascular disease (CVD) in future, which could be almost double. Its prevalence is 25%–50% on the basis of data from different countries, and it varies with age, sex, birth weight, and BMI. Regarding its pathophysiology, although several mechanisms have been proposed, the most validated ones include renin–angiotensin– aldosterone system activation, oxidative stress, inflammatory cytokines, sympathetic overdrive, and central nervous system activation. Therapeutic lifestyle changes are the foundation for all therapies in individuals with PHTN that are recommended by almost al l guidelines. Drug therapy has also been studied in a few trials and is recommended in high-risk patients.

 
Keywords
Prehypertension
Cardiovascular disease
Lifestyle changes
Systolic blood pressure,
Diastolic blood pressure
 
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Journal of Preventive Cardiology
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Print ISSN: 2249-4308
Online ISSN: 2277-6559
 
Frequency: Quarterly
 
 
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