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Literature review backs JNC 7's emphasis on prehypertension.

ATLANTA -- The controversial emphasis on "prehypertension" in the latest national high blood pressure guidelines is warranted, George A. Mensah, M.D., said at a prevention conference on heart disease and stroke sponsored by the Centers for Disease Control and Prevention.

Issued last year, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) sparked debate by defining a new class of prehypertension that applies to patients with a systolic blood pressure of 120-139 mm Hg or a diastolic blood pressure of 80-89 mm Hg.

Under this new classification, millions of Americans with blood pressures that were previously considered normal were suddenly categorized as being at risk for hypertension and its related complications. JNC 7 calls for lifestyle-based interventions to reduce risk in these patients.

A review of the relevant literature indexed in the National Library of Medicine's PubMed database through March 2004 confirms that such interventions are indeed needed in this new category of patients, which comprises about one-third of adults in the United States. The review showed that, compared with normal blood pressure, prehypertension is associated with higher prevalences of high cholesterol, obesity, and diabetes, and it doubles the risk of progression to hypertension, Dr. Mensah, acting director of the National Center for Chronic Disease Prevention and Health Promotion at the CDC, Atlanta, reported in a poster.

The risk factor-adjusted hazard ratio for cardiovascular disease associated with prehypertension is 1.5-2.0 in men and over 2.0 in women, he said.

Aggressive public health strategies are needed to provide education about prehypertension and to reduce the associated risks, he concluded.


Tallahassee Bureau
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Title Annotation:Cardiovascular Medicine
Author:Worcester, Sharon
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Nov 1, 2004
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