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Pre-Hypertension: Rationale for Pharmacotherapy
Pre-hypertension, defined as blood pressure 120–139/80–89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure
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| Published in: | Current hypertension reports 2013-12, Vol.15 (6), p.669-675 |
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| Language: | English |
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| container_end_page | 675 |
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| container_title | Current hypertension reports |
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| creator | Egan, Brent M. Laken, Marilyn A. |
| description | Pre-hypertension, defined as blood pressure 120–139/80–89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure |
| doi_str_mv | 10.1007/s11906-013-0387-7 |
| format | article |
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Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure <120/<80 mmHg, with an incidence rate of 8–20 % annually. Blood pressures in the upper half of the pre-hypertensive range also roughly double risk for cardiovascular events, even in the absence of progression to hypertension. Despite excess risk, guidelines recommend lifestyle interventions only for people with pre-hypertension in the absence of diabetes mellitus or clinical cardiovascular or chronic kidney disease. While efficacious, lifestyle changes have limited population effectiveness as Americans are heavier and their nutritional patterns less DASH-like than before DASH was published. Prevalent hypertension is higher in African Americans than Caucasians, but prevalent pre-hypertension is similar. African Americans experience a more rapid transition from pre-hypertension to hypertension than Caucasians with pre-hypertension. Interventions that normalize racial differences in incident hypertension could, over time, improve racial equity in prevalent hypertension and related clinical complications. Individuals with pre-hypertension can be safely treated with antihypertensive medications to significantly reduce incident hypertension. Given the evidence, practical clinical trials in African Americans with pre-hypertension to reduce and eliminate racial disparities in incident hypertension have merit. The results of these trials could provide the foundation for clinical guidelines to reduce racial disparities in prevalent hypertension and associated clinical cardiovascular and renal diseases.</description><identifier>ISSN: 1522-6417</identifier><identifier>EISSN: 1534-3111</identifier><identifier>DOI: 10.1007/s11906-013-0387-7</identifier><identifier>PMID: 24142744</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Animals ; Antihypertensive Agents - therapeutic use ; Blood Pressure Determination - methods ; Cardiology ; Family Medicine ; General Practice ; Heart Diseases - physiopathology ; Humans ; Hypertension ; Internal Medicine ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Nephrology ; Prehypertension - drug therapy ; Prehypertension - physiopathology ; Prevention of Hypertension: Public Health Challenges (P Muntner ; Primary Care Medicine ; Risk Factors ; Section Editor</subject><ispartof>Current hypertension reports, 2013-12, Vol.15 (6), p.669-675</ispartof><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-1dd8b42e841917decefadac8e85f3703e963e145035bbf3f55c40f194e750aea3</citedby><cites>FETCH-LOGICAL-c372t-1dd8b42e841917decefadac8e85f3703e963e145035bbf3f55c40f194e750aea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24142744$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egan, Brent M.</creatorcontrib><creatorcontrib>Laken, Marilyn A.</creatorcontrib><title>Pre-Hypertension: Rationale for Pharmacotherapy</title><title>Current hypertension reports</title><addtitle>Curr Hypertens Rep</addtitle><addtitle>Curr Hypertens Rep</addtitle><description>Pre-hypertension, defined as blood pressure 120–139/80–89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure <120/<80 mmHg, with an incidence rate of 8–20 % annually. Blood pressures in the upper half of the pre-hypertensive range also roughly double risk for cardiovascular events, even in the absence of progression to hypertension. Despite excess risk, guidelines recommend lifestyle interventions only for people with pre-hypertension in the absence of diabetes mellitus or clinical cardiovascular or chronic kidney disease. While efficacious, lifestyle changes have limited population effectiveness as Americans are heavier and their nutritional patterns less DASH-like than before DASH was published. Prevalent hypertension is higher in African Americans than Caucasians, but prevalent pre-hypertension is similar. African Americans experience a more rapid transition from pre-hypertension to hypertension than Caucasians with pre-hypertension. Interventions that normalize racial differences in incident hypertension could, over time, improve racial equity in prevalent hypertension and related clinical complications. Individuals with pre-hypertension can be safely treated with antihypertensive medications to significantly reduce incident hypertension. Given the evidence, practical clinical trials in African Americans with pre-hypertension to reduce and eliminate racial disparities in incident hypertension have merit. The results of these trials could provide the foundation for clinical guidelines to reduce racial disparities in prevalent hypertension and associated clinical cardiovascular and renal diseases.</description><subject>Animals</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure Determination - methods</subject><subject>Cardiology</subject><subject>Family Medicine</subject><subject>General Practice</subject><subject>Heart Diseases - physiopathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Nephrology</subject><subject>Prehypertension - drug therapy</subject><subject>Prehypertension - physiopathology</subject><subject>Prevention of Hypertension: Public Health Challenges (P Muntner</subject><subject>Primary Care Medicine</subject><subject>Risk Factors</subject><subject>Section Editor</subject><issn>1522-6417</issn><issn>1534-3111</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LAzEQhoMoVqs_wIsUvHiJzSTZTepNilqhYBE9h-zuxLbsl8nuof_eXbeKCJ5mYJ55h3kIuQB2A4ypaQCYsZgyEJQJrag6ICcQCUkFABz2Pec0lqBG5DSELWO821LHZMQlSK6kPCHTlUe62NXoGyzDpipvJy-26arNceIqP1mtrS9sWjVr9LbenZEjZ_OA5_s6Jm8P96_zBV0-Pz7N75Y0FYo3FLJMJ5KjljADlWGKzmY21agjJxQTOIsFgoyYiJLECRdFqWQOZhJVxCxaMSbXQ27tq48WQ2OKTUgxz22JVRsMyBi0jkCrDr36g26r1ncPfFFMCx0r3lEwUKmvQvDoTO03hfU7A8z0Ns1g03Q2TW_T9MmX--Q2KTD72fjW1wF8AEI3Kt_R_zr9b-on7jF9_w</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Egan, Brent M.</creator><creator>Laken, Marilyn A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Pre-Hypertension: Rationale for Pharmacotherapy</title><author>Egan, Brent M. ; Laken, Marilyn A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-1dd8b42e841917decefadac8e85f3703e963e145035bbf3f55c40f194e750aea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Animals</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure Determination - methods</topic><topic>Cardiology</topic><topic>Family Medicine</topic><topic>General Practice</topic><topic>Heart Diseases - physiopathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Nephrology</topic><topic>Prehypertension - drug therapy</topic><topic>Prehypertension - physiopathology</topic><topic>Prevention of Hypertension: Public Health Challenges (P Muntner</topic><topic>Primary Care Medicine</topic><topic>Risk Factors</topic><topic>Section Editor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egan, Brent M.</creatorcontrib><creatorcontrib>Laken, Marilyn A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Current hypertension reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egan, Brent M.</au><au>Laken, Marilyn A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre-Hypertension: Rationale for Pharmacotherapy</atitle><jtitle>Current hypertension reports</jtitle><stitle>Curr Hypertens Rep</stitle><addtitle>Curr Hypertens Rep</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>15</volume><issue>6</issue><spage>669</spage><epage>675</epage><pages>669-675</pages><issn>1522-6417</issn><eissn>1534-3111</eissn><abstract>Pre-hypertension, defined as blood pressure 120–139/80–89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure <120/<80 mmHg, with an incidence rate of 8–20 % annually. Blood pressures in the upper half of the pre-hypertensive range also roughly double risk for cardiovascular events, even in the absence of progression to hypertension. Despite excess risk, guidelines recommend lifestyle interventions only for people with pre-hypertension in the absence of diabetes mellitus or clinical cardiovascular or chronic kidney disease. While efficacious, lifestyle changes have limited population effectiveness as Americans are heavier and their nutritional patterns less DASH-like than before DASH was published. Prevalent hypertension is higher in African Americans than Caucasians, but prevalent pre-hypertension is similar. African Americans experience a more rapid transition from pre-hypertension to hypertension than Caucasians with pre-hypertension. Interventions that normalize racial differences in incident hypertension could, over time, improve racial equity in prevalent hypertension and related clinical complications. Individuals with pre-hypertension can be safely treated with antihypertensive medications to significantly reduce incident hypertension. Given the evidence, practical clinical trials in African Americans with pre-hypertension to reduce and eliminate racial disparities in incident hypertension have merit. The results of these trials could provide the foundation for clinical guidelines to reduce racial disparities in prevalent hypertension and associated clinical cardiovascular and renal diseases.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24142744</pmid><doi>10.1007/s11906-013-0387-7</doi><tpages>7</tpages></addata></record> |
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| ispartof | Current hypertension reports, 2013-12, Vol.15 (6), p.669-675 |
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| subjects | Animals Antihypertensive Agents - therapeutic use Blood Pressure Determination - methods Cardiology Family Medicine General Practice Heart Diseases - physiopathology Humans Hypertension Internal Medicine Medicine Medicine & Public Health Metabolic Diseases Nephrology Prehypertension - drug therapy Prehypertension - physiopathology Prevention of Hypertension: Public Health Challenges (P Muntner Primary Care Medicine Risk Factors Section Editor |
| title | Pre-Hypertension: Rationale for Pharmacotherapy |
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