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July/August 2005 Annals of Family Medicine tip sheet

PERSONS CONSIDERED PREHYPERTENSIVE AT A GREATER RISK FOR CARDIOVASCULAR MORBIDITY
Prehypertension is associated with increased risk for cardiovascular disease, according to a study from researchers with the Medical University of South Carolina. These findings support the latest recommendations from the Joint National Commission on Prevention, Detection, Evaluation, and treatment of High Blood Pressure (JNC 7), which added prehypertension as a new risk category. The expert panel recommended lifestyle modifications for all prehypertensive people, defined as those with systolic blood pressure levels between 120 and 139 mm Hg, or diastolic blood pressure levels between 80 and 90 mm Hg.

Analyzing nationally-representative data with 18 years of follow-up, researchers found that people with prehypertension are 1.79 times as likely to have a major cardiovascular event than those with normal blood pressure. Even after adjustment for cardiovascular risk factors, researchers found that the relationship between prehypertension and cardiovascular disease persists with a 1.32 times greater risk of major cardiovascular event over normal blood pressure. The authors assert that these findings support recommendations for physicians to actively target lifestyle modifications and multiple risk reduction in their prehypertensive patients. Epidemiologic data from the 1999-2000 National Health and Nutrition Examination Survey estimates that 31 percent of the population is prehypertensive and more than 88 percent of these people have a least one major cardiovascular risk factor.

An accompanying editorial to this article considers the study's implications along with the recent recommendations of the JNC 7 for practicing physicians. The editorial asserts that given the risk associated with prehypertension and its increasing prevalence in practice, primary care physicians must think about how they practice when it comes to blood pressure and what might need
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Contact: Kristin Robinson
kristinr@aafp.org
913-906-6000
American Academy of Family Physicians
26-Jul-2005


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