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Special Issues in Hypertension pp 3–12Cite as

Prehypertension: Definitions, Clinical Significance and Therapeutic Approaches—To Treat or not to Treat?

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Abstract

Because of its large prevalence and association with higher cardiovascular (CV) risk, prehypertension negatively affects public health. Prehypertension starts as a minor blood pressure (BP) elevation in childhood and young adulthood. Thereafter, BP in the prehypertension group increases steeply. This BP acceleration is associated with the restructuring of resistance arteries. In rats with spontaneous hypertension (SHR) and in humans, lowering BP with drugs that act on the renin–angiotensin system reverses arteriolar changes. In SHR, a short period of early treatment prevented subsequent accelerated hypertension. We investigated whether in prehypertension a period of treatment may postpone the development of hypertension. Two years after discontinuation of treatment, there was a modest suppression of new hypertension. Guidelines suggest lifestyle modifications for the management of prehypertension, but treatment can be initiated in patients with additional CV risk factors.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, 2368 Cardiovascular Center, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5853, USA

    Stevo Julius

  2. Hospital de Clínicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina

    Carlos A. Feldstein

Authors
  1. Stevo Julius
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  2. Carlos A. Feldstein
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Correspondence to Stevo Julius .

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Editors and Affiliations

  1. , Internal Medicine, American University of Beirut Medical Ce, Riad El Solh, Beirut, 1107-2020, Lebanon

    Adel E. Berbari

  2. Clinica Medica, Ospedale S. Gerardo, Università di Milano-Bicocca, V .Donizetti 106, Milano, Monza, 20133, Italy

    Giuseppe Mancia

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Julius, S., Feldstein, C.A. (2012). Prehypertension: Definitions, Clinical Significance and Therapeutic Approaches—To Treat or not to Treat?. In: Berbari, A., Mancia, G. (eds) Special Issues in Hypertension. Springer, Milano. https://doi.org/10.1007/978-88-470-2601-8_1

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  • DOI: https://doi.org/10.1007/978-88-470-2601-8_1

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2600-1

  • Online ISBN: 978-88-470-2601-8

  • eBook Packages: MedicineMedicine (R0)

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