Why You Should Be Concerned About Borderline Hypertension

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Written by Eli Ben-Yehuda

On November 30, 2022

Many people develop high blood pressure during their lifetime. More than one in three Americans fall into a somewhat murky risk zone, known as prehypertension or borderline hypertension, where blood pressure is above the upper boundary of “normal” (120/80 mmHg) but have not yet crossed into the hypertensive territory.

Hypertension, defined as a blood pressure reading of 140/90 mmHg or above, is the primary risk factor for heart attack and stroke. Additionally, it sets the stage for other serious conditions, such as kidney failure, blood vessel damage, vision loss, and dementia.

But these perils do not suddenly appear, as blood pressure readings cross the 140/90 mm Hg threshold. Instead, your risks of heart disease and other complications creep up as your numbers do.

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Why borderline hypertension is important?

“We don’t treat people with pre-hypertension with medications unless they have other medical conditions that put them at higher risk, such as coronary artery disease, diabetes, or chronic kidney disease,” says Dr. Randall Zusman, a hypertension specialist at Harvard-affiliated Massachusetts General Hospital.

He adds, “But very few people are going to avoid getting high blood pressure, so what you’re really doing when treating borderline hypertension is delaying the need for these medications”.

One of the dangers of being pre-hypertensive is this false sense of, “well it is not so bad so I can wait to make changes.”

Yet this is the perfect place to start making changes before the damage is done. Just because your only pre-hypertensive does not mean you are safe.

For example, borderline hypertension is tied to a 28 percent increased risk of death from cardiovascular disease and a 41 percent higher risk of stroke death, compared to people in the same studies with normal blood pressure.

Most of the raised risk was seen among people at the high end of the pre-hypertension range, with readings between 130-139/85-89, the researchers note, suggesting doctors may want to consider that when deciding how to treat slightly elevated blood pressure.

What can I do about my Borderline Hypertension?:

Check your diet

Consider following the DASH diet, which is rich in fruits, vegetables, whole grains, and low-fat dairy products. It curbs fat and cholesterol.

It also restricts sodium, which can raise blood pressure, and emphasizes foods rich in calcium, potassium, and magnesium, minerals that help lower blood pressure.

Watch the salt

Most experts recommend cutting back on salt. Check the Nutrition Facts food label, limit processed foods, replace salt with herbs and spices, and don’t add too much salt to foods.

Once source recommends limiting sodium to no more than 2,300 milligrams (mg) a day, which is approximately one teaspoon of salt.

Move more

Get at least 30 minutes of moderate activity every day, most days of the week.

Get to a healthy weight

Extra pounds make pre-hypertension more likely. Physical activity and healthy eating can help you shed extra weight.

Limit alcohol

Drink no more than two drinks a day if you’re a man or no more than one if you’re a woman. If you don’t drink, don’t start.

Curb stress

It’s unclear whether chronic stress, by itself, can raise your blood pressure in the long run. But it can make you more likely to overeat and skip exercise, Stein says.

So change your stressful situations, or at least how you deal with them. Find healthy ways to ease stress and consider counseling.

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Keep up with your blood pressure

If you can, buy a home monitor, and take your blood pressure twice day: once in the morning and once at night, Stein says.

“One very high reading is concerning, but one alone isn’t enough,” he says. “You want to see how it changes over time.”

If you have been diagnosed recently with borderline hypertension you are now in a position to lower your numbers before you have to start taking medication.

A pharmacological approach to controlling hypertension treats the symptoms but does not deal with the root cause. At this stage you can start to begin deal with the cause of your pre-hypertensive state. There are many natural ways to lower your blood pressure.

Additional Resources on Borderline Hypertension
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