Background: Prehypertension presents a reason for growing concern among healthcare providers in acute psychiatry. Its potential for progression to hypertension and cardiovascular disease in patients with mental illness is significantly higher than in persons without mental illnesses. Research shows that in most cases, patients with mental illness have the unhealthiest life style, because of their diet and lack of physical activity in comparison to the general population, and further explained that people who suffered from schizophrenia have a life expectancy of 10 years less compared to those without mental illness. Foreground: An increase in prevalence of prehypertension in the inpatient mental health population that received psychiatric treatment at a large metropolitan hospital was a major concern, especially since many of those patients were as young as 20 years of age. It was also observed that the continued use of previous terms high normal blood pressure and optimal blood pressure in consideration of treatment may have been a factor in not assigning the serious treatment approach for prevention of prehypertension progression to hypertension and cardiovascular events. Evidence-Based Practice Framework: The model for change to evidence-based practice was used to guide this project. Method: The purpose of this project was to determine if prehypertension was being identified and treated in acute adult psychiatry using the Joint National Committee on Prevention, Detection, Evaluation and Treatment of high blood pressure guideline on preventing hypertension and cardiovascular disease. A retrospective investigatory review of patients’ electronic medical records was conducted. Only medical records from January 2012 throug April 2014 were reviewed. Data was collected to determine if blood pressures within prehypertension range were identified. Prehypertension was listed as a problem and an active physical exercise prescribed. Results and Conclusion: The results from this project identified a lack of prehypertension being specifically identified as a problem and an active physical exercise prescribed as one method of treatement. This compelling data formed the basis for a protocol on management of prehypertension in acute psychiatry.