Beyond Blood Pressure Screening: A Rationale for Promoting the Primary Prevention of Hypertension

High blood pressure is a major public health problem in the United States. However, the underlying reasons for the chronic elevation of blood pressure (BP) are unknown in most cases of hypertension (HT), and medical care has focused on lowering already elevated BP, primarily by pharmacologic means. Although an important factor in the development of HT appears to be a genetic predisposition, other potentially modifiable lifestyle risk factors associated with elevated BP have been identified. This article describes the scientific rationale for encouraging health promotion specialists to focus on the primary prevention of abnormally elevated blood pressure. Nonbehavioral risk factors such as increasing age, history of HT, Black ancestry, and consistent BP readings in the higher range of normality, and behavioral factors including dietary excesses and deficiencies, excessive body fat, a sedentary life style, and frequent episodes of unmanageable emotional stress are addressed. Recommendations are made based on scientific evidence supporting the relationships between these risk factors and the development of HT.