Prehypertension

What is prehypertension?

Prehypertension is blood pressure that’s slightly higher than normal. A normal reading is 120 millimeters of mercury (mmHg) over 80 millimeters of mercury. With prehypertension, your first number can be up to 139 or your second could be up to 89.

Sometimes, healthcare providers use the word “elevated” for your blood pressure if the first number is between 120 and 129 and the second number is below 80. They may use the term “stage 1 high blood pressure” if your first number is between 130 and 139 and your second number is between 80 and 89. Prehypertension lumps these together in one category.

When your numbers reach 140/90, it’s hypertension (high blood pressure).

Is prehypertension bad?

Yes, it’s a cause for concern. People who have prehypertension have a risk of heart failure, heart attack or stroke that’s two to three times greater than that of people who don’t. Many people with prehypertension get hypertension at some point. Several studies have found that many people with prehypertension develop hypertension within three or four years.

How common is prehypertension?

Prehypertension is very common. An estimated 1 in 3 people have prehypertension.

What are the symptoms?

Prehypertension doesn’t have symptoms. Checking your blood pressure is the only way to know if you have prehypertension.

What are the complications of prehypertension?

People with prehypertension often have early signs (but not symptoms) of atherosclerosis. These may include:

• Carotid artery wall layers that are thicker than normal.
• An enlarged heart chamber.
• More calcium deposits in your coronary arteries than normal.

What causes prehypertension blood pressure?

Researchers don’t know exactly what causes high blood pressure, but they do know many of the factors that can contribute to it. Among other things, too much salt and alcohol and not enough exercise makes your blood pressure rise. More than 95% of people with high blood pressure don’t have just one cause of it. For those in the other 5%, the cause is another condition, such as:

• Sleep apnea.
• Kidney disease.
• Thyroid disease.

What are the risk factors for prehypertension?

People who are more likely to get prehypertension are those who:

• Use tobacco products.
• Have a body mass index (BMI) greater than 25.
• Have a parent or sibling with high blood pressure.

How is prehypertension diagnosed?

If your blood pressure is higher than normal at several different appointments, your provider may diagnose you with prehypertension. They’ll measure your blood pressure during two or more visits and get an average of the numbers. To check your blood pressure, they use a painless device that inflates and then deflates a cuff around your arm.

The prehypertension range is between 120 and 139 for the first number or 80 to 89 for the second number.

Should prehypertension be treated?

Yes, prehypertension should be treated so it doesn’t get worse. Blood pressure doesn’t improve on its own.

How is prehypertension treated?

For most people with prehypertension, treatment consists of changing their habits to lower their blood pressure. You can:

• Exercise regularly.
• Reach and maintain a weight that’s healthy for you.
• Stop using tobacco products.
• Eat foods that have less salt and fat in them, such as in the DASH diet.
• Limit alcohol to one drink per day (two per day for men and people assigned male at birth).
• Manage your stress.

Healthcare providers can treat prehypertension with blood pressure medicines. However, a provider may only recommend medication if you have diabetes, kidney disease or cardiovascular disease. Many different types of antihypertensive medicines can lower your blood pressure. Any of these can have side effects, so let your provider know if you need to switch to a different one.

How can I reduce my risk of prehypertension?

A number of factors can lead to a person developing prehypertension. You can reduce your risk of prehypertension with these habits:

• Avoid tobacco products (including smokeless tobacco and vaping).
• Exercise several times a week.
• Manage the stress in your life.
• Limit how much alcohol you drink.
• Cut back on the amount of salt you eat.
• Stay at a healthy weight.

What can I expect if I have prehypertension?

A major study found that people who have prehypertension are at a higher risk for heart disease and stroke than those with lower blood pressure. Many people with prehypertension go on to develop hypertension over time, and damage from it adds up. Also, having hypertension increases your risk of kidney disease and Type 2 diabetes.

If you catch prehypertension early, you can change your daily habits and lower your risk of getting high blood pressure. This can help you lower your risk of cardiovascular (heart and blood vessel) disease as well.

When should I see my healthcare provider?

You should have an annual physical (also known as a wellness visit or checkup) with your provider, but you may need to see them more often if you have prehypertension. They may want to see if changing your habits decreases your blood pressure. Because prehypertension can lead to hypertension, they’ll want to see you often enough to catch it early if that happens.

What questions should I ask my doctor?

Questions you can ask your healthcare provider may include:

• How drastically do I need to change my diet to improve my blood pressure?
• Do you recommend medicine for my prehypertension?
• How much exercise do I need?
• Are some types of exercise better than others for improving my blood pressure?

A note from Cleveland Clinic

Everyone would like to have normal blood pressure, but many people don’t. You’re not alone if you have prehypertension. The good news is that you can improve it by making some changes in how you live. Ask your healthcare provider if you need resources for bringing your weight down or stopping the use of tobacco products. Making changes now pays off in better heart health for your future self.