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Screening For Prehypertension

Published on Jun 02, 2016 and last reviewed on Dec 23, 2022   -  4 min read


Prehypertension is a risk factor for heart and brain problems. Read the article to know the ways to manage prehypertension.

Screening For Prehypertension


Many patients get to know their raised blood pressure at the time of diagnosis of heart attack, stroke, or kidney disease (end organ failure), which would have been prevented if treated at an early stage. People diagnosed with hypertension represent the "tip of an iceberg." Prehypertension should be taken seriously. It is a step toward getting effects with diseases like high blood pressure or hypertension, which can result in a wide range of health-related problems.

But that does not mean it cannot be reversed. Making key lifestyle changes makes it possible to lower blood pressure to healthy levels and protect the arteries from damage.

Classification of Hypertension:

Guidelines vary from time to time, but the generally accepted classification of hypertension is as follows. An average of two or more properly measured readings at each of two or more visits after an initial screen: (SBP - systolic blood pressure, DBP - diastolic blood pressure, and HTN - hypertension)

  • Normal - < 120 mmHg (millimetres of mercury) SBP or DBP < 90 mmHg.

  • Prehypertension - 120 -139 mmHg SBP or DBP 80 - 89 mmHg.

  • Hypertension Stage 1 - 140 -159 mmHg SBP or DBP 90 - 99 mmHg.

  • Hypertension Stage 2 - HTN >/= 160 mmHg SBP or DBP >/= 100 mmHg

The prevalence of prehypertension among adults is approximately 37 percent, with the highest among the 30 to 39 years of age group, which indicates that awareness is necessary for a regular blood pressure check-up.

What Can Cause Prehypertension?

Prehypertension can develop for many reasons. This includes:

Lack of physical activity - A sedentary lifestyle can increase the blood pressure in the arteries. Therefore, exercising is recommended to strengthen the heart and help it pump blood more efficiently.

Higher sodium intake - Sodium increases the pressure of blood in the arteries. Examples of high-sodium foods include processed meats, store-bought soups, sauces, and packaged meals.

Smoking- The chemicals in nicotine Trusted Source can constrict blood vessels, which increases blood pressure.

Alcohol intake- An excessive intake of alcohol can also increase blood pressure by constricting (narrowing) the blood vessels.

Lack of sleep- The blood pressure naturally decreases during sleep, so it is very important to have sound sleep. But if a person can not get enough sleep, blood pressure may stay high for a longer time.

Who Is at Higher Risk of Developing Prehypertension?

The following are the risk factors for developing prehypertension.

  • Older people over 65 years of age.

  • Overweight or obese.

  • Black non-Hispanic.

  • People suffering from diabetes.

  • A family history of hypertension.

Why Should Hypertension Be Diagnosed and Treated?

Hypertension currently causes two-thirds of all strokes and half of all cases of ischemic heart disease. Reduction in high blood pressure leads to large reductions in stroke, heart failure, renal failure, aortic dissection, coronary events, and death.


It is an entity where SBP >120 -139 mmHg or DBP 80-89 mmHg. Multiple epidemiological studies demonstrated an increased cardiovascular risk in patients with prehypertension.

People with prehypertension have an increased risk of progression to sustained hypertension, the prevalence of hypertension increases from approximately 10 percent at the age of 30 years to as high as 90 percent after the age of 65 years.

Framingham's hypertension risk prediction score may help identify prehypertensive patients at the greatest risk for progression to hypertension.

The risk calculator includes variables like age, sex, family history of hypertension, body mass index, and smoking. The most important predictors of these are higher baseline blood pressure and older age.

Screening for Hypertension:

The optimal interval for screening is not known. 2007 USPSTF (United States Preventive Services Task Force) guidelines recommended screening every two years for persons with SBP <120 mmHg and DBP <80 mmHg and yearly for people with SBP 120-139 mmHg or DBP 80-89 mmHg.

How to Manage Prehypertension?

TROPHY study (Trial Of Preventing Hypertension) results showed that there is no role for pharmacotherapy in prehypertension except in special conditions like diabetes, chronic kidney disease, etc.

As per The Joint National Committee”s the seventh report on evaluation, detection, treatment, and prevention of high blood pressure recommendations, patients with prehypertension who do not have diabetes, chronic kidney disease, end organ damage, or clinical evidence of cardiovascular disease, are generally treated with non-pharmacological therapies.

Major non-pharmacological therapies that aid in decreasing blood pressure are as follows:

1) Weight Reduction:

Maintain normal body weight (BMI 18.5 to 24.9 kg/m2). This can reduce blood pressure by 5 to 20 mmHg per 10 kg weight loss.

2) Adopt DASH Eating Plan:

DASH (Dietary Approach To Stop Hypertension) consists of fruits, vegetables, legumes, low fat dairy products with reduced saturated and total fat. This can reduce blood pressure by 8 to 14 mmHg.

3) Dietary Sodium Restriction:

Reduce dietary sodium intake to not more than 100 mEq/day (milliequivalent) (2.4 g sodium or 6 g of sodium chloride). This can reduce BP by 2 to 8 mmHg.

4) Physical Activity:

Involving in regular physical activity such as walking at speed or brisk walking for at least 30 minutes per day, four to five days a week. This can reduce BP by 4 to 9 mmHg.

5) Limit Alcohol Consumption:

Limit consumption of alcohol to not more than two drinks per day in men and not more than one drink in women and lighter weight persons. This can reduce BP by 2 to 4 mmHg.

What Are the Complications Associated With Prehypertension?

The following are the complications associated with prehypertension that can not be ignored because some of the conditions can be life-threatening.

  • Heart attack.

  • Heart failure.

  • Stroke.

  • Transient ischemic attack.

  • Angina (chest pain).

  • Kidney disease.


Hypertension is one of the common problems reported all over the world. Still, people are not aware of it. Prehypertension is a stage between normal blood pressure and developing hypertension. Prehypertension does not need serious treatment, a bit of lifestyle modification, physical activity and healthy eating will help. It is recommended to check blood pressure regularly and get proper treatment to avoid unfortunate circumstances.


Frequently Asked Questions


How Is Prehypertension Tested?

Prehypertension can be tested by checking the blood pressure of an individual. Blood pressures can be measured in millimeters of mercury (mmHg). When the systolic pressure is between 120 to139 millimeters of mercury (mm Hg) or diastolic pressure is between 80 to 89 mm Hg, it is considered prehypertension.


Is a Screening Test Available for Hypertension

Screening for hypertension is done by measuring an individual's blood pressure using mercury or a digitally validated device and an inflatable cuff. The patient is made to sit in a relaxed position with the arm supported at the heart level and the legs uncrossed.


How Often Is Hypertension Screening Performed?

It is recommended to check the blood pressure of children once a year. Whereas, in healthy adults, once a month, checking is recommended. On the other hand, in adults consuming antihypertensive medicine, blood pressure should be checked once a week.


When Should We Begin Screening for Blood Pressure?

The American Heart Association and many other institutes recommend routine screening starting at the age of three.


What Are the Factors That Can Influence Blood Pressure?

The following factors can make changes in blood pressure:
- Age.
- Lack of exercise.
- Tobacco use.
- Increased alcohol consumption.
- Increased salt consumption.
- Decreased potassium level.
- Stress.
- Pregnancy.
- Chronic health conditions.


How Can We Prevent Prehypertension?

Prehypertension can be prevented by:
- Eating healthy food.
- Regular exercise.
- Maintaining a healthy weight.
- Avoid smoking.
- Limit alcohol consumption.
- Manage stress.


Is It Required to Take Medications to Control Prehypertension?

Usually, drugs are not recommended for people with prehypertension. However, to control prehypertension, drugs may be recommended for people with other health conditions, such as diabetes mellitus (high blood sugar), coronary artery disease (narrowing of the major blood vessels of the heart), and chronic kidney disease.


Can Anxiety Cause Hypertension?

Anxiety can cause temporary spikes in blood pressure. However, it does not cause long-term high blood pressure.


What Are the Symptoms in Women With Increased Blood Pressure?

The common symptoms in women with increased blood pressure include:
- Fatigue.
- Headaches.
- Chest discomfort.
- Shortness of breath.


How Does an Individual Know They Have Prehypertension?

When the systolic pressure ranges between 120 to139 mm Hg (millimeters of mercury) or the diastolic pressure ranges between 80 to 89 mm Hg, it indicates prehypertension.


What Causes Prehypertension?

Prehypertension can be caused due to:
- Family history of hypertension.
- Unhealthy diet.
- Certain lifestyle choices.


Does Insufficient Sleep Cause Increased Blood Pressure?

Lack of sleep can cause increased blood pressure and risk of heart disease. Insufficient sleep over time can also lead to unhealthy habits that can harm the heart, including less motivation to be physically active, higher stress levels, and unhealthy food choices.


What Are the Factors That Make Variations in Blood Pressure?

Measurement technique, equipment accuracy, and various patient factors such as anxiety can cause variations in blood pressure.


Is It Possible to Go Back to Normal From Prehypertension?

Prehypertension is a warning sign of blood pressure in the future. However, some people can bring prehypertension back to normal through exercise, weight loss, and other changes for a healthy lifestyle.

Last reviewed at:
23 Dec 2022  -  4 min read




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