Prehypertension doubles the risk of cardiovascular disease, with a global prevalence of 21.9% to 52%, highlighting the need for lifestyle modifications and potential pharmacotherapy like the Polypill.
What are the underlying pathophysiological processes of prehypertension and the current/potential therapeutic options to prevent cardiovascular disease?
This review highlights the pathophysiology of prehypertension and suggests that beyond lifestyle modifications, pharmacological interventions like RAS inhibitors or a 'Polypill' should be investigated to prevent cardiovascular disease.
Prehypertension (PHTN) is a global major health risk that subjects individuals to double the risk of cardiovascular disease (CVD) independent of progression to overt hypertension. Its prevalence rate varies considerably from country to country ranging between 21.9% and 52%. Many hypotheses are proposed to explain the underlying pathophysiology of PHTN. The most notable of these implicate the renin-angiotensin system (RAS) and vascular endothelium. However, other processes that involve reactive oxygen species, the inflammatory cytokines, prostglandins and C-reactive protein as well as the autonomic and central nervous systems are also suggested. Drugs affecting RAS have been shown to produce beneficial effects in prehypertensives though such was not unequivocal. On the other hand, drugs such as β-adrenoceptor blocking agents were not shown to be useful. Leading clinical guidelines suggest using dietary and lifestyle modifications as a first line interventional strategy to curb the progress of PHTN; however, other clinically respected views call for using drugs. This review provides an overview of the potential pathophysiological processes associated with PHTN, abridges current intervention strategies and suggests investigating the value of using the "Polypill" in prehypertensive subjects to ascertain its potential in delaying (or preventing) CVD associated with raised blood pressure in the presence of other risk factors.
Sulayma Albarwani (Wed,) conducted a review in Prehypertension. Therapeutic options (lifestyle modifications and pharmacotherapy) was evaluated. Prehypertension doubles the risk of cardiovascular disease, with a global prevalence of 21.9% to 52%, highlighting the need for lifestyle modifications and potential pharmacotherapy like the Polypill.