let me be clear - I fall into the camp of health care / public health folks who DO NOT think that prehypertension is a disease, that it should be categorized as one or that it should be medicated.

I do not know what triggered a WSJ article on hypertension and it's possible consequences (stroke, heart attack and death) this week.  The point of the article was not to discuss the number one killer of Americans (except North Carolinian men apparently) which is heart disease, but to introduce the seven or eight year old debate on pre hypertension.

Hypertension, or high blood pressure is determined simply by numbers.  If one has a blood pressure reading, consistently over time, that is 140/90 or higher, they are hypertensive.  Medication is almost always given at this time, unless, in my opinion, the patient is fortunate enough to have a medical practitioner who suggests non medicine treatment first. (there is certainly a time when the blood pressure reading is so high that it MUST be addressed with medicine immediately)

Some, and I am guessing they either ARE the drug company, have stocks in the company, do research for the company or are paid by the company, believe that people who have numbers ten points below 140/90 should be called prehypertensive.  In other words, 130+/80+ .  These persons are now diseased.  The pre hypertensive person should be given medication to get the numbers down before it becomes a true (?) hypertensive case.

But others, NO -  they might say to a patient, "your number is a little higher than I'd like to see, so - stop smoking, eat less and lose weight, exercise every day, don't drink so much, use less salt and watch the caffeine and stress, if you can..."

This they contend can prevent said person from having a heart attack or stroke - it could prevent said person from having to take medicine later - to prevent the even more likely heart attack or stroke associated with the  higher blood pressure-

SURELY a person would want to follow those sensible recommendations in order to live, right?

And let us not really be fooled into thinking that pills are better (necessary at times, but better?) as they are an inconvenience to take (every day, multiple times - or they do not work), expensive, and oh, they have side effects so blood work is often needed on a regular basis.

Anyways, if the drug camp gets their way on the prehypertensive category - pretty soon it will be 120/70 is awful close to 130/80 so......