High-Normal Blood Pressure — More “High” Than “Normal”

On the basis of evidence from multiple clinical trials, it is recommended that antihypertensive therapy be instituted for patients with confirmed hypertension — that is, when the systolic blood pressure exceeds 140 mm Hg or the diastolic blood pressure exceeds 90 mm Hg.1 However, many patients who have a myocardial infarction, stroke, or other cardiovascular event have blood pressures below these thresholds. In fact, it is recognized that cardiovascular risk increases linearly at blood-pressure levels lower than those that usually trigger the use of antihypertensive therapy — specifically at a systolic pressure of 130 to 135 mm Hg and a . . .