Have These Conditions Gone By the Wayside?
Updated July 08, 2014.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
I was at the airport a few months ago waiting to "pre-board." I heard a few comments on how nonsensical the whole concept of pre-boarding is. You are either boarding the airplane, or you are waiting in line to board the airplane. There is simply no in-between.
Has the same thing occurred with prehypertension and prediabetes? With the advent of the new high blood pressure guidelines you no longer hear about the word prehypertension.
Some medical professionals think that the idea of prehypertension is idiotic, ie, you either have high blood pressure or you don't.
I vehemently disagree.
Prehypertension is a real condition; it is warning sign, a flashing yellow light that you need to change some things in your life as you are at high risk of developing high blood pressure. My own opinion is that with the new blood pressure guidelines which raises the limits of blood pressure norms to 140/90 and 150/90 depending on your age and the presence of other medical conditions, both doctors and patients alike will wait until the blood pressure is at the above range. Just above these numbers is stage 1 hypertension for which prescription medication is indicated to treat this stage of hypertension "according to the guidelines."
Again, just my opinion, however, following this logic we have missed the opportunity to try and prevent the high blood pressure from occurring in the first place. If nothing else, the word prehypertension will put a name to a condition, make concrete the idea of a hypertension work in progress whose path can be completely altered with a few interventions.
For the record, the old definition of pre-hypertension is a blood pressure of 120-139 and/or a diastolic blood presssure of 80-89 mmHg. A normal blood pressure used to be 120/80 mmHg. I understand the purpose of the guidelines; I am all for personalizing the blood pressure treatment for the age and prior history of an individual, but I have a hard time accepting the "new normal" guidelines of 150/90 mmHg.
Why? Because when people truly engage in a healthy lifestyle, exercise, and change to a plant or Mediterranean based diet, I see that their blood pressure numbers decrease to 110-120/70-80 mmHg. Maybe we are not giving ourselves enough credit thinking that it is not even possible for the average American to even achieve these numbers.
So, the guidelines are changed.
What about prediabetes? This is a real condition defined as a blood glucose level between 100 and 126 mg/dL. It is a condition where many people find themselves. It is a real diagnosis and there are many books written about the condition of prediabetes. Often, where you see prediabetes you also see prehypertension or hypertension present. Prediabetes is often associated with increased insulin resistance. Increased insulin resistance is associated with high blood pressure. Insulin resistance is associated with endothelial dysfunction.
Prediabetes is also a warning sign as well. It means that you need to change your lifestyle, exercise and change your nutrition. Just as with high blood pressure, you want to do all that you can to avoid getting diabetes.
What happens if you don't? You then become an "accumulator" of conditions. You develop high blood pressure and diabetes, and all of a sudden you begin to "accumulate" other conditions including heart disease, high cholesterol and triglycerides, metabolic syndrome,obesity, peripheral arterial disease, congestive heart failure, stroke.....
You go to your doctor and your medical history looks like a shopping list.
Don't be an accumulator; be a preventer.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
I was at the airport a few months ago waiting to "pre-board." I heard a few comments on how nonsensical the whole concept of pre-boarding is. You are either boarding the airplane, or you are waiting in line to board the airplane. There is simply no in-between.
Has the same thing occurred with prehypertension and prediabetes? With the advent of the new high blood pressure guidelines you no longer hear about the word prehypertension.
Some medical professionals think that the idea of prehypertension is idiotic, ie, you either have high blood pressure or you don't.
I vehemently disagree.
Prehypertension is a real condition; it is warning sign, a flashing yellow light that you need to change some things in your life as you are at high risk of developing high blood pressure. My own opinion is that with the new blood pressure guidelines which raises the limits of blood pressure norms to 140/90 and 150/90 depending on your age and the presence of other medical conditions, both doctors and patients alike will wait until the blood pressure is at the above range. Just above these numbers is stage 1 hypertension for which prescription medication is indicated to treat this stage of hypertension "according to the guidelines."
Again, just my opinion, however, following this logic we have missed the opportunity to try and prevent the high blood pressure from occurring in the first place. If nothing else, the word prehypertension will put a name to a condition, make concrete the idea of a hypertension work in progress whose path can be completely altered with a few interventions.
For the record, the old definition of pre-hypertension is a blood pressure of 120-139 and/or a diastolic blood presssure of 80-89 mmHg. A normal blood pressure used to be 120/80 mmHg. I understand the purpose of the guidelines; I am all for personalizing the blood pressure treatment for the age and prior history of an individual, but I have a hard time accepting the "new normal" guidelines of 150/90 mmHg.
Why? Because when people truly engage in a healthy lifestyle, exercise, and change to a plant or Mediterranean based diet, I see that their blood pressure numbers decrease to 110-120/70-80 mmHg. Maybe we are not giving ourselves enough credit thinking that it is not even possible for the average American to even achieve these numbers.
So, the guidelines are changed.
What about prediabetes? This is a real condition defined as a blood glucose level between 100 and 126 mg/dL. It is a condition where many people find themselves. It is a real diagnosis and there are many books written about the condition of prediabetes. Often, where you see prediabetes you also see prehypertension or hypertension present. Prediabetes is often associated with increased insulin resistance. Increased insulin resistance is associated with high blood pressure. Insulin resistance is associated with endothelial dysfunction.
Prediabetes is also a warning sign as well. It means that you need to change your lifestyle, exercise and change your nutrition. Just as with high blood pressure, you want to do all that you can to avoid getting diabetes.
What happens if you don't? You then become an "accumulator" of conditions. You develop high blood pressure and diabetes, and all of a sudden you begin to "accumulate" other conditions including heart disease, high cholesterol and triglycerides, metabolic syndrome,obesity, peripheral arterial disease, congestive heart failure, stroke.....
You go to your doctor and your medical history looks like a shopping list.
Don't be an accumulator; be a preventer.
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