J Korean Med Assoc.  2011 Oct;54(10):1013-1019.

The scientific evidence for the management of prehypertensives and high risk group

• Chun BY
• Shin JY

Abstract

The establishment of the concept of "prehypertension" has drawn attention to the preclinical range of blood pressure with clinical and public health significance. Prehypertensive individuals require lifestyle modifications (risk factor management) to prevent the progressive rise in blood pressure and cardiovascular diseases (CVDs). Also, for those with hypertension, adoption of healthy lifestyles is an indispensable part of hypertension control, because lifestyle modifications enhance antihypertensive drug efficacy and prevent or delay the incidence of CVD. For the effective management of hypertension at the national level in Korea, evidence-based recommendations for lifestyle modification method and education programs are urgently needed. Thus, to obtain evidence-based data, intensive support from the government level is needed for further long-term follow-up studies and randomized clinical trials for high-risk groups and prehypertensives.

Keyword

Prehypertension; Risk factors; Preventive health service; Evidence-based medicine

MeSH Terms

Adoption
Blood Pressure
Cardiovascular Diseases
Evidence-Based Medicine
Hypertension
Incidence
Korea
Life Style
Prehypertension
Preventive Health Services
Public Health
Risk Factors

Reference

1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute. National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003. 42:1206–1252.

2. Ministry of Health Welfare and Family Affairs. Korea Centers for Disease Control & Prevention. Daegu Metropolitan City. KHyDDI (Korea Hypertension Diabetes Daegu Initiative) project report. 2008. Daegu: Kyungpook National University.

3. Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in nonhypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001. 358:1682–1686.

4. Greenlund KJ, Croft JB, Mensah GA. Prevalence of heart disease and stroke risk factors in persons with prehypertension in the United States, 1999-2000. Arch Intern Med. 2004. 164:2113–2118.

5. Mainous AG 3rd, Everett CJ, Liszka H, King DE, Egan BM. Prehypertension and mortality in a nationally representative cohort. Am J Cardiol. 2004. 94:1496–1500.

6. MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J. Blood pressure, stroke, and coronary heart disease. Part 1. Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990. 335:765–774.

7. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002. 360:1903–1913.

8. Washio M, Tokunaga S, Yoshimasu K, Kodama H, Liu Y, Sasazuki S, Tanaka K, Kono S, Mohri M, Takeshita A, Arakawa K, Ideishi M, Nii T, Shirai K, Arai H, Doi Y, Kawano T, Nakagaki O, Takada K, Hiyamuta K, Koyanagi S. Role of prehypertension in the development of coronary atherosclerosis in Japan. J Epidemiol. 2004. 14:57–62.

9. Toikka JO, Laine H, Ahotupa M, Haapanen A, Viikari JS, Hartiala JJ, Raitakari OT. Increased arterial intima-media thickness and in vivo LDL oxidation in young men with borderline hypertension. Hypertension. 2000. 36:929–933.

10. King DE, Egan BM, Mainous AG 3rd, Geesey ME. Elevation of C-reactive protein in people with prehypertension. J Clin Hypertens (Greenwich). 2004. 6:562–568.

11. Chrysohoou C, Pitsavos C, Panagiotakos DB, Skoumas J, Stefanadis C. Association between prehypertension status and inflammatory markers related to atherosclerotic disease: The ATTICA Study. Am J Hypertens. 2004. 17:568–573.

12. Ministry of Health and Welfare. Report on 2008 National Health and Nutrition Survey. 2011. Seoul: Ministry of Health and Welfare.

13. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010. 303:2043–2050.

14. Karanja NM, Obarzanek E, Lin PH, McCullough ML, Phillips KM, Swain JF, Champagne CM, Hoben KP. Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension Trial. DASH Collaborative Research Group. J Am Diet Assoc. 1999. 99:8 Suppl. S19–S27.

15. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997. 336:1117–1124.

16. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001. 344:3–10.

17. Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR. Writing Group of the PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003. 289:2083–2093.

18. Svetkey LP, Simons-Morton DG, Proschan MA, Sacks FM, Conlin PR, Harsha D, Moore TJ. Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control. J Clin Hypertens (Greenwich). 2004. 6:373–381.

19. Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a metaanalysis of randomized controlled trials. Hypertension. 2003. 42:878–884.

20. Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas NC, Mattfeldt-Beman M, Belden L, Bragg C, Millstone M, Raczynski J, Brewer A, Singh B, Cohen J. Trials for the Hypertension Prevention Research Group. Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med. 2001. 134:1–11.

21. Intersalt an international study of electrolyte excretion and blood pressure Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ. 1988. 297:319–328.

22. Elliott P, Stamler J, Nichols R, Dyer AR, Stamler R, Kesteloot H, Marmot M. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. Intersalt Cooperative Research Group. BMJ. 1996. 312:1249–1253.

23. Cutler JA, Follmann D, Allender PS. Randomized trials of sodium reduction: an overview. Am J Clin Nutr. 1997. 65:2 Suppl. 643S–651S.

24. Braith RW, Pollock ML, Lowenthal DT, Graves JE, Limacher MC. Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age. Am J Cardiol. 1994. 73:1124–1128.

25. Hagberg JM, Montain SJ, Martin WH 3rd, Ehsani AA. Effect of exercise training in 60- to 69-year-old persons with essential hypertension. Am J Cardiol. 1989. 64:348–353.

26. Roman O, Camuzzi AL, Villalon E, Klenner C. Physical training program in arterial hypertension. A long-term prospective follow-up. Cardiology. 1981. 67:230–243.

27. Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2000. 35:838–843.

28. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002. 136:493–503.

29. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the Trials of Hypertension Prevention, Phase I. JAMA. 1992. 267:1213–1220.

30. The Trials of Hypertension Prevention Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. Arch Intern Med. 1997. 157:657–667.

31. Chainani-Wu N, Weidner G, Purnell DM, Frenda S, Merritt-Worden T, Pischke C, Campo R, Kemp C, Kersh ES, Ornish D. Changes in emerging cardiac biomarkers after an intensive lifestyle intervention. Am J Cardiol. 2011. 108:498–507.

32. Svetkey LP. Management of prehypertension. Hypertension. 2005. 45:1056–1061.

33. Julius S, Nesbitt SD, Egan BM, Weber MA, Michelson EL, Kaciroti N, Black HR, Grimm RH Jr, Messerli FH, Oparil S, Schork MA. Trial of Preventing Hypertension (TROPHY) Study Investigators. Trial of Preventing Hypertension (TROPHY) Study Investigators. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med. 2006. 354:1685–1697.

34. Luders S, Schrader J, Berger J, Unger T, Zidek W, Bohm M, Middeke M, Motz W, Lubcke C, Gansz A, Brokamp L, Schmieder RE, Trenkwalder P, Haller H, Dominiak P. PHARAO Study Group. The PHARAO study: prevention of hypertension with the angiotensin-converting enzyme inhibitor ramipril in patients with high-normal blood pressure: a prospective, randomized, controlled prevention trial of the German Hypertension League. J Hypertens. 2008. 26:1487–1496.

35. Fuchs FD. Prehypertension: the rationale for early drug therapy. Cardiovasc Ther. 2010. 28:339–343.

36. Franklin SS, Jacobs MJ, Wong ND, L'Italien GJ, Lapuerta P. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001. 37:869–874.

37. Somes GW, Pahor M, Shorr RI, Cushman WC, Applegate WB. The role of diastolic blood pressure when treating isolated systolic hypertension. Arch Intern Med. 1999. 159:2004–2009.

38. Staessen J, Bulpitt CJ, Fagard R, Lijnen P, Amery A. The influence of menopause on blood pressure. J Hum Hypertens. 1989. 3:427–433.

39. Yeungnam University. Management Center for Health Promotion. Development of national cardiocerebrovascular disease prevention and control strategy (2011-2015). 2011. Seoul: Management Center for Health Promotion.