Marta Michalska, Zanchetti Alberto, Wong Nathan D, Malyszko Jolanta, Rysz Jacek, Banach Maciej
Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113; 90-549 Lodz, Poland.
Curr Vasc Pharmacol. 2014;12(4):586-97. doi: 10.2174/15701611113119990126.
In 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure established a definition of a new category of BP levels called 'prehypertension' (preHT) that included individuals with a systolic BP of 120-139 mm Hg or a diastolic BP of 80-89 mm Hg. Patients with preHT were considered to be at increased risk for progression to hypertension and in individuals with BP in the range 130/80 to 139/89 mmHg the risk of developing hypertension was twice as high as in subjects with lower values. Still then there has been a large debate whether the introduction of preHT was based on evidence and as a consequence, it was fully justified. It has been suggested that the term prehypertension may in many subjects create anxiety and a need for unnecessary medical visits and examinations. This group of patients is also very heterogeneous and it has been pointed out that subdividing preHT group into individuals with normal BP and high normal BP would much better correspond to the continuum of BP risk for CV disease. Finally, despite some data suggesting the potential benefits of antihypertensive therapy in patients with preHT (high normal BP), there are still no hard evidences on the outcome reduction by giving antihypertensive drugs in these individuals.
2003年，美国国家联合委员会关于高血压预防、检测、评估和治疗的第七次报告确立了一种新的血压水平类别——“高血压前期”（preHT）的定义，其中包括收缩压为120 - 139毫米汞柱或舒张压为80 - 89毫米汞柱的个体。高血压前期患者被认为进展为高血压的风险增加，在血压范围为130/80至139/89毫米汞柱的个体中，患高血压的风险是血压值较低者的两倍。即便如此，关于引入高血压前期这一概念是否有充分依据仍存在很大争议，其合理性也备受质疑。有人认为，高血压前期这一术语可能会让许多人产生焦虑，导致不必要的就医和检查。这组患者的情况也非常复杂，有人指出将高血压前期组细分为血压正常和血压略高正常的个体，将更符合心血管疾病血压风险的连续性。最后，尽管有一些数据表明抗高血压治疗对高血压前期（血压略高正常）患者可能有益，但仍没有确凿证据表明给这些个体服用抗高血压药物能降低不良后果。
