From Our 2010 Archives

Prehypertension, Prediabetes Predict Heart Risk

1 in 3 Healthy Adults Has Prehypertension, 1 in 4 Has Prediabetes

By Denise Mann
WebMD Health News

Reviewed By Laura J. Martin, MD

May 3, 2010 (New York) -- Prehypertension and prediabetes, especially when they occur together, are early warning signs of heart disease in seemingly healthy adults, according to new research presented at the American Society of Hypertension's 25th annual meeting in New York.

"This is a clear, present, and preventable danger," says study researcher Alok K. Gupta, MD, an assistant professor at the Pennington Center Biomedical Research Center of Louisiana State University in Baton Rouge, during a news conference.

Two out of three sudden deaths occur in people who have not been diagnosed with heart disease, and the new study may provide important clues on how to identify these individuals before it is too late, he says.

Prehypertension and Prediabetes

Prehypertension is defined as a systolic blood pressure reading between 120 and 139 and a diastolic blood pressure of 80 to 89. Systolic blood pressure is the upper number in a blood pressure measurement and refers to the pressure when the heart beats while pumping blood. Diastolic blood pressure, the lower number, is the pressure when the heart is at rest between beats. A blood pressure reading of less than 120/80 is considered ideal.

Prediabetes refers to blood sugar (glucose) levels between 100 to 125 milligrams per deciliter of blood (mg/dL). Ideal fasting blood levels should be less than 100 mg/dL.

According to Gupta, one in three seemingly healthy people has prehypertension, and one in four has prediabetes. One in 10 has both of these conditions.

Individuals with both prehypertension and prediabetes are also more likely to be obese, have high levels of markers of systemic inflammation, and high insulin levels compared to their counterparts without these two "pre" conditions. These individuals also had high total cholesterol levels, high levels of low density lipoprotein (LDL) or "bad" cholesterol, high levels of dangerous blood fats called triglycerides, and low levels of high density lipoprotein (HDL) or "good" cholesterol, when compared to their counterparts who did not have prediabetes or prehypertension, the study showed.

The good news is that these conditions are easily identified, Gupta says. Testing for prediabetes involves a finger stick test for blood glucose levels, and resting blood pressure measurement can identify those individuals with prehypertension, he explains.

"If you have both, you must initiate lifestyle changes," he tells WebMD. "Losing about 7% of your body weight is known to help, and so is incorporating 150 minutes of exercise a week," he says. "If implemented and followed, this will reverse the subtle danger that exists."

Lifestyle Changes

George Bakris, MD, a professor of medicine and the director of the Hypertension Center at the University of Chicago, puts it this way: "If you have prediabetes, it's the fire, and prehypertension is the gasoline that's added to the fire."

Unfortunately, "doctors don't tell patients they have prediabetes. They say, 'You are at risk for diabetes', so you need to ask, 'What is my fasting blood sugar?'" says Bakris, the president-elect of the American Society of Hypertension.

"If it is in the triple digits, you have a problem. You better lose weight, exercise, and reduce your carbohydrate intake or you will get diabetes," says Bakris.

Genes play a role in diabetes risk, but changing your life can help significantly forestall the seemingly inevitable, he says.

"If both of your parents have diabetes, you are at high risk, but if you do all the lifestyle stuff, you will buy yourself at least a decade, which is a big deal," he tells WebMD.

SOURCES: American Society of Hypertension's 25th Annual meeting, New York, May 1- 4, 2010.

Alok K. Gupta, MD, assistant professor, Pennington Center Biomedical Research Center, Louisiana State University, Baton Rouge.

George Bakris, MD, professor, director, Hypertension Center, University of Chicago, Illinois.

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