| Prehypertension: should we be treating with pharmacologic therapy? | |
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MedLine Citation:
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PMID: 19124429 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Prehypertension, defined by Seventh Joint National Committee (JNC 7) as a blood pressure (BP) 120-139/80-89 mm Hg, was controversial. Approximately 31-37% of US adults are prehypertensive, and approximately 12-14% have BP of 130-139/85-89 mm Hg or ;Stage 2' prehypertension, is associated with approximately 3-fold greater likelihood of developing hypertension and roughly twice the cardiovascular events than BP <120/80 mm Hg. Lifestyle change is the only intervention recommended for most prehypertensives. When fully implemented, lifestyle changes lower BP and prevent cardiovascular events, but evidence for community-wide effectiveness is limited. The Trial of Preventing Hypertension (TROPHY) documented that angiotensin receptor blockade safely lowers BP and prevents and/or delays hypertension in Stage 2 prehypertensives. Prehypertensives with diabetes or nephropathy are at high risk and should receive antihypertensive treatment according to JNC 7. Epidemiological data suggest that the number needed to treat to prevent a cardiovascular event in these at-risk Stage 2 prehypertensives is similar to Stage 1 hypertensives when both groups have one or more concomitant risk factors. Clinical trials are urgently needed to address this question. In the absence of clinical trials data, we believe it is prudent for the concerned clinician to consider initiating antihypertensive pharmacotherapy in selected Stage 2 prehypertensive patients at significant absolute risk for progression to hypertension and cardiovascular events. |
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Authors:
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Brent M Egan; Shawna D Nesbitt; Stevo Julius |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Therapeutic advances in cardiovascular disease Volume: 2 ISSN: 1753-9447 ISO Abbreviation: - Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2009-01-06 Completed Date: 2009-02-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101316343 Medline TA: Ther Adv Cardiovasc Dis Country: England |
Other Details:
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Languages: eng Pagination: 305-14 Citation Subset: IM |
Affiliation:
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Medical University of South Carolina, Charleston, SC 29425, USA. eganbm@musc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Angiotensin II Type 1 Receptor Blockers / therapeutic use Antihypertensive Agents / therapeutic use Cardiovascular Diseases / prevention & control Disease Progression Humans Hypertension / drug therapy*, epidemiology, prevention & control* Life Style |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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