Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM On Twitter
  • JABFM On YouTube
  • JABFM On Facebook
OtherResearch Letter

Do Clinicians Tell Patients They Have Prehypertension?

Anthony J. Viera, Fatima Bangura, C. Madeline Mitchell, Ana Cerna and Philip Sloane
The Journal of the American Board of Family Medicine January 2011, 24 (1) 117-118; DOI: https://doi.org/10.3122/jabfm.2011.01.100206
Anthony J. Viera
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fatima Bangura
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
C. Madeline Mitchell
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ana Cerna
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Philip Sloane
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Background: The clinical utility of the prehypertension label is questionable. We sought to estimate how often patients with prehypertension are being told about it by their primary care clinicians.

Methods: We conducted a cross-sectional study of adult patients visiting practices within the North Carolina Family Medicine Research Network in summer 2008. Non-hypertensive patients were asked whether a doctor or other health care provider had ever told them they had “prehypertension”; a subsample of patients with measured blood pressure (BP) in the prehypertension range was asked the same question.

Results: Of 1008 non-hypertensive patients, 1.9% indicated being told they had prehypertension. Among a subsample of 102 patients with measured BP in the prehypertension range, 2.0% indicated being told they had prehypertension.

Conclusion: Few patients who probably have prehypertension are being told about it by clinicians.

  • Patient-Provider Communication
  • Prehypertension

Prehypertension is extremely common. In primary care clinics, as many as 40% of adults who do not have hypertension have prehypertension.1 We recently reported that there appeared to be neither harmful nor helpful effects of labeling patients as prehypertensive.2 Whether clinicians are actually using the term “prehypertension” with patients has not been specifically examined to our knowledge, although our recent paper suggests that very few patients with prehypertension are told about it.2 The purpose of this study was to estimate how often patients with prehypertension are told about it.

Methods

We conducted a cross-sectional study of patients visiting seven primary care practices within the North Carolina Family Medicine Research Network (NC-FM-RN).3 In summer 2008, research assistants offered participation to all adult English and Spanish-speaking patients in waiting rooms of these seven practices across NC during a 3-week period. In addition to demographic and other health questions, participants were asked to indicate whether a doctor or other health care provider had told them they had “high blood pressure or hypertension” (Yes/No), “prehypertension” (Yes/No), or “borderline hypertension” (Yes/No). To estimate the prehypertension “eligible” population, we used an independently validated automatic oscillometric monitor with a cuff that accommodates both standard and large adult arms4 to measure blood pressures of a subsample of participants while in the waiting rooms. This study was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill School of Medicine.

Results

Of 1754 patients completing the survey (overall response rate 63.9%), 42.5% indicated a history of hypertension. Among those not indicating a history of hypertension (n = 1008), 4.3% indicated being told of borderline hypertension, and 1.9% indicated being told of prehypertension (Table 1). Less than 1% indicated both. Of a subsample of 182 patients without known hypertension who had BP measured as part of this study, 102 had BP in the prehypertension range. Among this group, 2.0% of patients indicated being told they have prehypertension and 3.9% indicated being told that their BP was borderline (Table 1).

View this table:
  • View inline
  • View popup
Table 1.

Percentage of Nonhypertensive Adult Patients Reporting being Told about Prehypertension or Borderline Hypertension

Comments

Few patients who probably have prehypertension recall being told about it. It is possible that patients were told about prehypertension and just do not recall it, but we think it more likely that clinicians do not use this term with patients. The term “borderline” might be preferred by clinicians, but we found that recollection of being told about borderline hypertension was only slightly more common. One possible explanation for not engaging patients in a discussion about prehypertension is that clinicians do not find it useful in practice. It is possible that clinicians counsel patients about lifestyle modifications that will reduce their chances of developing hypertension without telling them specifically about prehypertension.

Acknowledgments

The authors thank Katharine Butler, Dax Varkey, Shannon Skinner, and Jessica Taylor, who helped to administer the surveys and collect data.

Notes

  • Funding: Funding was provided in part by a grant from National Institute of Diabetes and Digestive and Kidney Diseases grant no. T35 DK07386 to the University of North Carolina at Chapel Hill School of Medicine. Data collection and analysis for this project was funded by a National Institutes of Health grant no. K07 AG21587 (PS). Dr. Viera's time was funded by a National Institutes of Health/National Center for Research Resources grant no. 1KL2RR025746-01.

  • Conflict of interest: none declared.

  • Received for publication September 9, 2010.
  • Accepted for publication September 14, 2010.

References

  1. ↵
    Viera AJ. The new “normal” blood pressure: what are the implications for family medicine? J Am Board Fam Med 2007; 20: 45–51.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    Viera AJ, Lingley K, Esserman D. Eeffects of labeling patients as prehypertensive. J Am Bard Fam Med 2010; 23: 571–83.
    OpenUrl
  3. ↵
    Sloane PD, Callahan L, Kahwati L, Mitchell CM. Development of a practice-based patient cohort for primary care research. Fam Med 2006; 38: 50–7.
    OpenUrlPubMed
  4. ↵
    Viera AJ, Hinderliter AL. Validation of the HEM-780REL with easy wrap cuff for self-measurement of blood pressure according to the European Society of Hypertension International Protocol. Blood Press Monit 2007; 12: 335–8.
    OpenUrlPubMed
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family Medicine: 24 (1)
The Journal of the American Board of Family Medicine
Vol. 24, Issue 1
January-February 2011
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Do Clinicians Tell Patients They Have Prehypertension?
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 14 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Do Clinicians Tell Patients They Have Prehypertension?
Anthony J. Viera, Fatima Bangura, C. Madeline Mitchell, Ana Cerna, Philip Sloane
The Journal of the American Board of Family Medicine Jan 2011, 24 (1) 117-118; DOI: 10.3122/jabfm.2011.01.100206

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Do Clinicians Tell Patients They Have Prehypertension?
Anthony J. Viera, Fatima Bangura, C. Madeline Mitchell, Ana Cerna, Philip Sloane
The Journal of the American Board of Family Medicine Jan 2011, 24 (1) 117-118; DOI: 10.3122/jabfm.2011.01.100206
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Acknowledgments
    • Notes
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Evaluating the Framingham Hypertension Risk Prediction Model in Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
  • Family Practice is a Highly Complex Business
  • Google Scholar

More in this TOC Section

  • Factors Associated with Intention to Vaccinate Children 0-11 Years of Age Against COVID-19
  • Perceived Effectiveness and Overall Satisfaction of Using a Toilet Stool to Prevent or Treat Constipation: An Analysis of Online Comments
  • Communication of Drug Efficacy Information via a Popular Online Platform
Show more Research Letters

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2023 American Board of Family Medicine

Powered by HighWire