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Classification and external resources
ICD-9-CM 796.2

Prehypertension, also known as high normal blood pressure, is an American medical classification for cases where a person's blood pressure is elevated above normal, but not to the level considered hypertension (high blood pressure). Prehypertension is blood pressure readings with a systolic pressure from 120 to 139 mm Hg or a diastolic pressure from 80 to 89 mm Hg. Readings greater than or equal to 140/90 mm Hg are considered hypertension. Classification of blood pressure is based upon two or more readings at two or more separate occasions separated by at least one week. The seventh report of the Joint National Committee (JNC 7) proposed the new labeling for elevated blood pressure values below 140/90 to more accurately communicate the tendency of blood pressure to rise with age.

Prehypertension is often asymptomatic (without symptoms) at the time of diagnosis. Only extremely elevated blood pressure (malignant hypertension) can, in rare cases, cause headaches, visual changes, fatigue, or dizziness, but these are nonspecific symptoms which can occur with many other conditions. Thus, blood pressures above normal can go undiagnosed for a long period of time.

Elevated blood pressure develops gradually over many years usually without a specific identifiable cause. However, possible medical causes, such as medications, kidney disease, adrenal problems or thyroid problems, must first be excluded. High blood pressure that develops over time without a specific cause is considered benign or essential hypertension. Blood pressure also tends to increase as a person ages.

To lower the risk of prehypertension progressing to hypertension, modification of lifestyle or behaviors is necessary.

A low-sodium, high potassium diet is recommended, along with increasing physical activity to at least thirty minutes a day most days of the week, quitting smoking, reducing alcohol consumption, and maintaining a healthy weight.

Specifically, a diet that is high in fruits and vegetables (aim for half of your meal including non-starchy vegetables, like leafy greens, beans, carrots, cucumbers, tomatoes, etc.), whole grains, low in refined grains (e.g., white breads and baked goods made from white flour), low in saturated fats ( e.g., fatty cuts of meat or fried foods) and low in sodium (homemade or minimally processed) have been demonstrated through randomized controlled studies to significantly lower blood pressure. These types of diet changes alone can lower blood pressure greater than any single drug therapy. The effects of both diet and sodium reduction work together, meaning the more you improve your diet to include less saturated fat, more fruits and vegetables and less saturated fat OR lower your sodium intake significantly below what is typical in industrialized nations, like the United States, the greater the benefit will be seen. Similarly, the better the quality of diet, the more the results will be seen. Significant results have been seen in 30 days.



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