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Prehypertension accounts for a substantial number of hospitalizations, nursing home admissions, and premature deaths

Together, prehypertension and residual hypertension account for 4.7 percent of hospital admissions, 9.7 percent of nursing home admissions, and 13.7 percent of deaths per 10,000 adults aged 25 to 74 years.

Prehypertension is a systolic blood pressure (SBP) of 120 to 139 mm Hg, a range previously considered normal. Hypertension begins at a SBP of 140 mm Hg; and residual hypertension is a SBP of 140 mm Hg or more even with treatment. About two-thirds of individuals aged 45 to 64 years and 80 percent of those aged 65 to 74 years have prehypertension or residual hypertension, either of which increases their risk of heart attack, heart failure, stroke, and kidney disease.

Prehypertension alone accounts for 3.4 percent of hospitalizations, 6.5 percent of nursing home stays, and 9.1 percent of deaths, according to a study supported in part by the Agency for Healthcare Research and Quality (HS07002 and HS11477).

Louise B. Russell, Ph.D., of Rutgers University, and her colleagues used a simulation model based on data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study to estimate the effects of prehypertension and residual hypertension on a representative sample of U.S. adults aged 25 to 74 years from NHANES III.

Except for women aged 25 to 44 years, more than a third of each age group in NHANES III had prehypertension. The number of problems attributable to prehypertension were greatest for men aged 45 to 64 years and men and women aged 65 to 74 years.

For more information, see "Effects of prehypertension on admissions and deaths: A simulation," by Dr. Russell, Elmira Valiyeva, Ph.D., and Jeffrey L. Carson, M.D., in the October 25, 2004, Archives of Internal Medicine 164, pp. 2119-2124.

Editor's Note: In another AHRQ-supported study on a related topic, researchers also analyzed data from NHANES III and found that prehypertensive individuals had a higher prevalence of elevated C-reactive protein (a marker of inflammation that independently predicts increased cardiovascular risk) than normotensive people. For more details, see King, D.E., Egan, B.M., Mainous III, A.G., and Geesey, M.E. (2004, October). "Elevation of C-reactive protein in people with prehypertension." (AHRQ grant HS10871). Journal of Clinical Hypertension 6(10), pp. 562-568.

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