Perspectives on prehypertension.
The Trial of Preventing Hypertension (TROPHY) investigated pharmacologic intervention in patients with prehypertension. TROPHY confirmed that treatment with candesartan 16 mg can prevent or postpone the development of hypertension, demonstrating a 66.3% reduction in hypertension incidence relative to placebo (26.8% absolute reduction) at 2 years, and a 15.6% reduction in hypertension incidence relative to placebo (9.8% absolute reduction) at 4 years. Further analyses of TROPHY may help to delineate the mechanisms behind this result more specifically, including those relating to components of the metabolic syndrome and markers of inflammation and early vascular change. The rate of progression and the concurrence of risk factors make a strong case for the development of a directive for closer follow-up and treatment. The potential for success in reducing cardiovascular events is great, given the prevalence of prehypertension and the likelihood of progression.
Nesbitt
Shawna D
SD
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-8899, USA. shawna.nesbitt@utsouthwestern.edu
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D004035:Diet Therapy; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012107:Research Design; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C077793:candesartan cilexetil