Diagnosed with Prehypertension -- Now What?

May 17, 2017 James DeCock, MD


The definition of prehypertension sounds like some sort of medical no-man's land--your blood pressure isn't below 120/80, which is considered normal, but it also isn't above 140/90, which is considered high. But prehypertension is actually a warning sign you should pay attention to, says James DeCock, MD, a board-certified family medicine physician at Mission Heritage Medical Group.

"With prehypertension, you have a much greater chance of developing high blood pressure, also known as hypertension," Dr. DeCock says.

"Hypertension can take its toll by overworking the heart and damaging the walls of blood vessels, making them susceptible to tears, ruptures or increased plaque build-up. That increases your chances of heart attack or stroke. Prehypertension can also cause damage to the heart, so it needs to be treated as soon as possible."

The most important treatment to lower your blood pressure at this prehypertension stage is making lifestyle changes. "That means no smoking, minimal alcohol consumption and, the big key, exercising and eating a healthy, low-salt diet to keep your weight down," Dr. DeCock says. "Aim for meals loaded with produce, whole grains and low-fat dairy while also avoiding processed foods as much as possible, which can be heavy on sodium. Consuming too much salt can lead to water retention in the body, which makes your blood vessels and heart work harder." The American Heart Association recommends eating no more than 1,500 milligrams of sodium daily, but your physician may suggest a different goal depending on your heart health.

When it comes to exercise, the target should be at least 150 minutes of moderate-intensity activity. "Some small studies have found that blood pressure may benefit from strength-training exercises," Dr. DeCock says. "If your doctor gives you the go-ahead, add that to your workout routine at least a couple of times each week."

If you have an underlying medical condition, medication could be a possibility to lower your prehypertension. A recent report in The Lancet, which analyzed 123 studies from 1966 to 2015, with almost 614,000 participants, recommended that patients with a history of heart, cardiovascular or chronic kidney diseases, or stroke or diabetes, should take medication to get their systolic reading (the top number) below 130.

"A heart weakened by higher-than-normal blood pressure can be dangerous for people who have a history of these diseases, which is why it's especially important to lower those blood pressure numbers," Dr. DeCock says. "But for those people with prehypertension and a normal health history, the best first step is making those healthier lifestyle changes."

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.


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