What is Prehypertension?

Hypertension is high blood pressure. Prehypertension is the state before hypertension when you're at high risk of developing full-blown high blood pressure if you don't take steps to improve your health. About one in five adults in the United States has prehypertension.

High blood pressure is serious. It puts you at risk for heart disease, stroke, kidney disease, blindness and dementia.

Blood Pressure and Hypertension

You need to know what your blood pressure is. This is especially important if you have a family history of high blood pressure. You should have a blood pressure measurement every year or two or more often if you have any abnormal readings.

If you suspect you may have high blood pressure or prehypertension or if you haven't had your blood pressure checked for a while, see a doctor. If it is high, you want to reduce it as soon as possible, even if you have to take medication. The consequences of untreated high blood pressure are significant to your health.

What is the Prehypertension Range?

You want your blood pressure to be lower than 120/80. If your blood pressure is 120/80, it's a warning sign of hypertension. Anything between 120/80 and 139/89 is prehypertension. Hypertension begins at 140/90.

If the top number of your blood pressure reading (systolic pressure) is 120 or higher, you may be able to reduce it by making lifestyle choices such as exercise and dietary changes. If the top number is 140 or higher, you may need to take prescription medication to reduce your blood pressure. You may not need to take medication for life. Your doctor can recommend ways to reduce your blood pressure and wean you off of medication.

Symptoms

You can't usually feel if you have high blood pressure, which is why there are no well-known prehypertension symptoms. Many people have no symptoms at all. But if your blood pressure is high, your heart is working too hard. The walls of your arteries have too much pressure against them. This forceful blood flow can harm your arteries, if you have this condition long enough without treatment.

Prehypertension Signs

Prehypertension signs and symptoms are limited. Typically, there are no physical symptoms with prehypertension. If a patient knows there is a family history of hypertension or high blood pressure, it is important to schedule regular monitoring of blood pressure. Blood pressure monitoring is the only way to determine if a patient has prehypertension, which is a blood pressure range that falls between 120/80 mm Hg-139/89 mm Hg. 

Causes

The causes for prehypertension can be due to a known family history of hypertension or high blood pressure, unhealthy diet, and certain lifestyle choices. Contrary to what is commonly assumed, aging is not a cause of prehypertension. Specifically, anything that creates more pressure on the artery wall (known as atherosclerosis), can lead to elevated blood pressure. Other conditions that can lead to elevated or high blood pressure include:

• Thyroid disease
• Adrenal disease
• Kidney disease
• Obstructive sleep apnea

Additionally, certain medications such as decongestants, cold remedies, birth control pills, over-the-counter pain medicine and certain prescription medications, can cause a temporary rise in blood pressure. Similarly, certain illegal substances, such as cocaine and amphetamines, can also cause a temporary rise in blood pressure.

Diagnosis

Diagnosis for prehypertension is assessed by a blood pressure test. For the test, a blood pressure cuff is placed around the arm and it provides feedback on systolic and diastolic pressure in the blood. Since blood pressure tends to fluctuate, it is recommended to take the average of two or more blood pressure readings done on separate occasions in a consistent manner. Blood pressure is considered to be in a normal range if it is below 120/80 mm Hg. If you have a family history of hypertension or high blood pressure, it is important to get regular blood pressure readings. A health care professional may also recommend an at home device that can monitor blood pressure on a more regular basis. 

Treatment

Treatment for prehypertension typically encompasses different lifestyle changes. If elevated blood pressure ever rises to stage 1 or stage 2 hypertension, a doctor may prescribe medication to help regulate blood pressure. Potential lifestyle changes include:

• Maintaining a healthy weight
• Maintaining a healthy diet and reducing sodium intake
• Implementing a consistent exercise plan and being more physically active
• Stopping the use of tobacco products
• Limiting alcohol consumption