Prehypertension: a possible target for antihypertensive medication.
Vascular changes associated with elevated blood pressure may precede the clinical diagnosis of hypertension. Even after the diagnosis is made, associated coronary heart disease and renal disease continue to progress, despite adequate blood pressure control. Early treatment of blood pressure may reduce the incidence of clinical hypertension and reduce the long-term consequences of hypertension. Animal studies have shown that early blood pressure lowering, through blockade of the renin-angiotensin system, prevents long-term hypertension. Prevention is an important goal in the treatment of hypertension. Our best attempts to prevent hypertension use nonpharmacologic methods of diet and exercise. These methods are fraught with difficulties of implementation and compliance that limit their success. Finding novel approaches to prevent hypertension may have a major impact on the incidence of hypertension. We are investigating the effect of 2 years of treatment with an angiotensin receptor blocker (candesartan cilexitil) compared with placebo, followed by 2 years of follow-up, on the incidence of hypertension in patients with high-normal blood pressure. Incidence of hypertension after discontinuation of active treatment will be compared with the incidence in the placebo group. There will be 1000 patients enrolled in the study, which will be completed in 2004.
Nesbitt
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Division of Hypertension, University of Michigan Medical Center, 3918 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0356, USA. snesbitt@umich.edu
Julius
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D057911:Angiotensin Receptor Antagonists; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D007333:Insulin Resistance / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D013777:Tetrazoles / Q000627:therapeutic use
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan