Q: I'm 60 years old. My blood pressure is around 130/80. In the past, I've always been told I have normal blood pressure. Now my doctor says I have "pre-hypertension." What does this mean? Do I need treatment?

A: I can understand your confusion. Here's how I explain it to my patients.

Blood pressure of less than 120/80 is normal. It also means that the person is at less risk of developing hypertension later on.

Blood pressure of 140/90 is considered high. If it is confirmed to be that high on later readings, then the person has hypertension.

Now we come to what doctors call "pre-hypertension." This means blood pressure that is between 120/80 and 139/89. Pre-hypertension rarely calls for drug therapy. But having a number in this range puts you at higher than average risk for developing hypertension later on.

The reason for this new term is to identify people like you who should take action now to help prevent hypertension. That doesn't mean you need medication. It does mean making lifestyle changes:

Lose weight if necessary.

Be more physically active. That includes doing aerobic exercise for at least 30 minutes five or more times per week.

Eat a healthy diet, including lots of vegetables, fruits and whole grains.

Reduce salt intake.

Limit alcohol use to no more than an average of one drink per day for women and two per day for men.

Here's what's most important: By taking action now, you lower your risk of complications from hypertension. You also reduce your chance of a heart attack, stroke, heart failure, kidney failure and early death.

(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.

For additional consumer health information, please visit http://www.health.harvard.edu.)

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