Afshin A. Divani, PhD, assistant professor of neurology, neurosciences and surgery and director of the Zeenat Qureshi Stroke Research Center at New Jersey Medical School
Why Watch
Your Blood Pressure?
by Jill Spotz
|
As the doctor blurts out two numbers, you can hardly hear him over the "RRRRIP" of the Velcro unfastening from your bicep. "What does that mean?" you ask. "Prehypertension," he states. You are shocked. "But I FEEL fine!"
rehypertension or slightly elevated blood pressure was recently added to the long list of diseases and disorders that we face as we age. In 2003, the Joint National Committee on High Blood Pressure named the condition as a category of blood pressure to reinforce the associated risks. Unfortunately for boomers, prehypertension tends to rear its ugly head in the mid 40s. According to the American Heart Association, nearly one in three adults with prehypertension will progress to high blood pressure within four years of being diagnosed. The statistics aren’t favorable, which is why it’s imperative to understand what the numbers indicate. Normal blood pressure is below 120 systolic (the upper number) and 80 diastolic (lower number). Prehypertension is a systolic pressure from 120 to 139 or a diastolic pressure from 80 to 89. Just like high blood pressure, prehypertension can cause damage to your body and increases the risk of heart attack and stroke.
Afshin A. Divani, PhD, assistant professor of neurology, neurosciences and surgery and director of the Zeenat Qureshi Stroke Research Center at New Jersey Medical School (NJMS), was one of the co-investigators who uncovered the connection between prehypertension and heart attack/cardiovascular disease last year. The study, which was headed by Adnan I. Qureshi, MD, professor of neurology and neurosciences at NJMS, was based on data obtained from the often cited Framingham Study and was recognized by the American Heart Association as one the top 10 research advances for 2005. The investigators at the Center published the results in Stroke. “We found a 47 percent attributable risk of heart attack and a 20 percent risk of cardiovascular disease in individuals with prehypertension,” says Divani. The average age of individuals who developed the condition in the Framingham Study was 42, the youngest of the current boomer generation. “Our data was taken from the pool of more than 11,000 residents of Framingham, Massachusetts, who enrolled in the original study in 1948. Since that time, participants continue to return every two years for a detailed medical history and physical examination,” explains Divani.
Divani is planning a follow-up study based on an in-hospital survey for U.S. patients with cardiovascular disease and stroke. “We have not paid enough attention to prehypertension,” he explains. Physicians agree that the use of hypertension medications and eliminating risk factors are ways to combat the problem. Earlier this year, the outcome of the first Trial of Preventing Hypertension (TROPHY), to test a medication in the treatment of prehypertension, showed promising results. There was a 66 percent relative risk reduction in the group treated with Atacand (a medication typically used to treat hypertension) compared to the group treated with a placebo.
At the younger end of the boomer generation, Divani is confident that as he ages, there will be advances in treating prehypertension and other cardiovascular risk factors. One exciting application on the horizon is the use of Micro-Electro-Mechanical Systems (MEMS). Essentially, miniature implantable machines will allow physicians to prescribe drug cocktails in precise doses, at different times and for separate conditions, like hypertension and high cholesterol. Imagine a tiny, silicone, implantable device with separate reservoirs for different drugs, dispensing medication on command. “This would eliminate the need for taking alternate medications at different times, missing doses or confusing medications,” explains Divani. MEMS technology is already being used in everything from blood pressure monitors to automobile suspensions.
Prehypertension – Time to Take It Seriously
Blood pressure tends to fluctuate so a diagnosis of prehypertension is based on the average of two or more readings taken during separate visits to the doctor. Certain chronic conditions like high cholesterol, diabetes and sleep apnea may increase the risk as well. Prehypertension is often symptom-less so it is important to know your risk factors which include:
- Being overweight
- A diet high in sodium or low in potassium
- A family history of high blood pressure
- A sedentary lifestyle
- Tobacco use
- Excessive alcohol use