The seventh edition of the United States Joint National Committee on prevention, detection and treatment of high blood pressure (BP) coined the term prehyperten-sion for a BP level of 120-139/80-89 mmHg . This was based on the acknowledgement of a continuous relationship between BP and cardiovascular risk and the increased risk of developing future hypertension defined as a BP of more than or equal to 140/90 mmHg in those subjects with a current BP between of 120-139/80-89 mmHg compared with those with a current BP lower than 120/80 mmHg. This new definition also aimed at raising awareness for the implementation of lifestyle changes in all prehypertensive subjects in order to lower cardiovascular risk. The European Society of Hypertension/European Society of Cardiology (ESH/ESC) Committee, however, kept the definition of high normal (130-139/85-89 mmHg), normal (120-129/80-84 mmHg) and optimal BP (< 120/80 mmHg) in the latest guidelines of 2007 [2]. One of the reasons for not adopting the definition of prehypertension was that there is a graded increase of risk for future hypertension, being higher in those with high normal than in those with normal BP, and thus, no need to join these two groups together [3,4]. Another reason was to avoid anxiety created by the term prehypertension. The major issue, however, was that even though lifestyle changes are certainly of value in subjects with this BP level, some may actually need antihypertensive drug treatment when taking their estimated total cardiovascular risk into account.
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