Harvard Heart Letter

When should we treat blood pressure?

Lifetime cardiovascular risk now plays a role in the decision.

High blood pressure (also known as hypertension) is a major risk factor for cardiovascular problems. It forces the heart to pump harder, making it thicker and less efficient over time. High blood pressure also damages the lining of the arteries, providing new sites for plaque growth and greatly increasing the risk of heart attack, heart failure, stroke, and kidney failure.

But the dangers of slightly elevated blood pressure—what doctors call prehypertension—are less clear. In fact, the cutoff point for optimal blood pressure is somewhat arbitrary. Consequently, doctors don't know exactly when blood pressure–lowering medications become beneficial and should be started.

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