Pre-hypertension can double a person’s chance of stroke

Pamela Egan Practical Practitioner

 

By: Pamela Egan, FNP-C CDE

 

 

Pre-hypertension can double a person’s chance of stroke

 

 

Dear Pam,

My blood pressure has been borderline (140/90) for the past nine months. My physician wants me to get on medicine, but I don’t want to start medications unless I really have to. Do you think I should start on B/P pills?


This is a tough question since I don’t know if you’ve implemented lifestyle modifications to lower your blood pressure.

Aerobic exercise is a must in lowering blood pressure. Can you walk 30 minutes a day? How’s your diet? Watch your salt and limit carbohydrate intake such as white flour, white sugar, bread, potatoes, past, rice, sweets, etc. High insulin levels in the blood can lead to high blood pressure. Are you drinking enough water each day? Are you overweight? Have you had your kidney function checked lately? Do you have diabetes?

Researchers with the Black Pooling Project have defined a new category of risk for stroke called pre-hypertension. That includes those with systolic pressures between 120-139mm Hg and diastolic pressures between 80-89mm Hg.

Both Caucasians and African Americans with pre-hypertension have twice the risk of stroke compared with those with lower blood pressures, reported at the American Stroke Association’s International Stroke Conference.

Researchers analyzed cardiovascular mortality rates according to four categories of blood pressure: normal, defined as a blood pressure below 120/80; pre-hypertensive 120-139/ 80-89; stage 1 hypertension 140-159/ 90-99; and stage 2 hypertension 160/100 or greater.

Hypertension was more common among black men and women, but pre-hypertension was more common among white men and women.

Overall, 30.3 percent of white men and 32.7 percent of white women were pre-hypertensive, compared with 15.8 percent of black men and 14.5 percent of black women. Stroke risk increased with each category of blood pressure, with stroke rates consistently higher for blacks compared with whites.

A new clinical trial is looking at a goal of 110/70. The lower the blood pressure the better. If lifestyle modifications have failed to lower your blood pressure to normal, then medication is needed to prevent stroke and heart attack.

Recent studies suggest many people with kidney disease don’t realize they’re headed for kidney failure. For people with high blood pressure or diabetes, regular tests of kidney function are crucial.

There’s probably 20 to 25 million people who have this condition, but they don’t know if they’re not symptomatic. A borderline blood pressure is a red flag that should be paid attention to.

With diabetes rates skyrocketing nationwide, an increasing number of Americans are vulnerable to kidney problems.

Studies in the 1990s confirmed that if kidney disease is caught early enough, preventive measures, such as careful monitoring of blood pressure and blood sugar levels, can help slow the progression of the disease. Patients at high risk of kidney disease, include those with high blood pressure, diabetes, a family history and minorities, should have their kidney function tested once a year.


This article was originally published February 21, 2005 in The St. Tammany News.

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