[From labile or borderline arterial hypertension to mild hypertension. Current data and practical management]. 1985

P Wicker, and M Dallocchio

The concept of labile hypertension (also called borderline hypertension) has been proposed to define those patients in whom blood pressure is sometimes below, sometimes above the frontier which separates normal and high blood pressure. Current evidence does not support the individualization of this concept, since numerous studies have demonstrated a similar or even higher blood pressure variability in hypertensive patients than that found in normotensive patients. The main objective, when measuring blood pressure, is to assess the risk of a cardiovascular event. It has been shown that the average value of several blood pressure determinations provides a better estimate of cardiovascular risk, and correlates better with hypertensive target organ disease, than a single blood pressure measurement. Therefore, we propose to define these so-called labile hypertensive patients on the basis of the average and to classify them into the category of mild hypertension, the later being defined as a diastolic blood pressure between 90 and 105 mmHg on several occasions according to the WHO. The increase in cardiovascular risk carried by a mild elevation in blood pressure, either untreated or treated with general health measures, is small, approximately 3% per year. Moreover, whereas the beneficial effects of pharmacological antihypertensive therapy have been demonstrated on a whole population basis, these effects remain controversial on an individual basis. Thus, it appears justified to give these hypertensive patients general health measures advice without any pharmacological therapy during the first months of follow-up. During this time, blood pressure measurements are repeated so that blood pressure status, and thus the need for pharmacological therapy, can be assessed more precisely.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002318 Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM. Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000959 Antihypertensive Agents Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. Anti-Hypertensive,Anti-Hypertensive Agent,Anti-Hypertensive Drug,Antihypertensive,Antihypertensive Agent,Antihypertensive Drug,Anti-Hypertensive Agents,Anti-Hypertensive Drugs,Anti-Hypertensives,Antihypertensive Drugs,Antihypertensives,Agent, Anti-Hypertensive,Agent, Antihypertensive,Agents, Anti-Hypertensive,Agents, Antihypertensive,Anti Hypertensive,Anti Hypertensive Agent,Anti Hypertensive Agents,Anti Hypertensive Drug,Anti Hypertensive Drugs,Anti Hypertensives,Drug, Anti-Hypertensive,Drug, Antihypertensive,Drugs, Anti-Hypertensive,Drugs, Antihypertensive
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative

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