More than 50 million Americans currently have hypertension. According to new guidelines issued in May 2003 by the National Heart, Lung, and Blood Institute (NHLBI), another 45 million Americans now have prehypertension.Recent research has proven that 90% of all Americans are destined to develop hypertension at some point in their lifetimes.1, 2 A recent large meta-analysis found that the risk of developing cardiovascular disease doubles every time the diastolic blood pressure (the low number) increases by 10 mmHg and/or the systolic blood pressure (the high number) increases by 20 mmHg. This increased risk starts at or below 115/75 mmHg.3It is now apparent that the rise in blood pressure seen in nearly all Americans as they reach middle and old age is unhealthful. Many people with blood pressure levels within what had been considered “normal” and everyone with what had been termed “high-normal” blood pressure are at a considerably increased risk for developing cardiovascular diseases, dementia and kidney failure.These new NHLBI guidelines should encourage more physicians to refer patients for medical nutritional therapy. In nearly all cases, a more healthful diet can lower blood pressure from the prehypertensive range to a far safer level. There is every reason to believe that most people with prehypertension who adopt a low-sodium, DASH-style diet can return their blood pressure to the optimal range and probably keep it there for the rest of their lives. By contrast, the aggressive use of drugs to lower blood pressure down to the optimal range (<110/70 mmHg) often comes with unpleasant and potentially serious adverse side effects.By James J. Kenney, PhD, RD.1. Salt Toxicity CPE?Course www.foodandhealth.com/cpecourses/salt_new.php2. JAMA 2002;287:1003-10103. Lancet 2002;360:1908