text_1: Personalized treatment for those in blood pressure 'gray zone'
text_2: This news release describes an analysis of data from the Multi-Ethnic Study of Atherosclerosis (MESA) study showing a link between a buildup of calcium in coronary arteries and heart attacks in patients with borderline high blood pressure, referred to here as “prehypertension.” The study asserts that coronary artery calcification (CAC) can be used to guide treatment decisions for these “gray zone” patients. Aside from an overreaching headline and sub-headline, the news release delivers essential information including costs, harms, availability, and study limitations. Nearly 30 percent of U.S. adults have prehypertension, defined as blood pressure between 120 and 139 for the first number (systolic) and/or 80 to 89 for the second number (diastolic). Preypertension is associated with a higher risk of heart attack as well as a heightened risk of developing high blood pressure, which increases the risk of stroke. But the concept of “prehypertension” is somewhat controversial. The most recent hypertension guidelines (JNC 8) do not include this classification. It’s still a leap of faith to imply that identifying this risk group and more aggressively treating their blood pressure would significantly reduce their cardiovascular risk. Patients generally are advised to make lifestyle changes such as exercise and weight loss, but medication is sometimes prescribed. A tool to better determine which patients would benefit from aggressive treatment — as coronary artery calcification scans might prove to be — could help clinicians make better recommendations, improving outcomes and reducing costs.