title: TROPHY study: Outcomes based on the Seventh Report of the Joint National Committee on Hypertension definition of hypertension.
abstract: Trial of Preventing Hypertension (TROPHY) investigated whether pharmacological treatment of prehypertension prevents or postpones stage 1 hypertension. Hypertension was originally defined when a participant had blood pressure (BP) >/=140 and/or >/=90 mm Hg at any three clinic visits over 4 years. Contemporary guidelines define hypertension if the BP is >/=140 and/or >/=90 at two consecutive visits. TROPHY results were recalculated based on the current definition. Participants with repeated BP of 130 - 139 and/or 85 - 89 mm Hg were randomly assigned to 2 years of candesartan or placebo, followed by 2 years of placebo for all. All participants received lifestyle counseling at every visit. When participants reached hypertension, antihypertensive treatment was initiated. The 4-year incidence of hypertension was significantly (P < .001) lower than previously reported in the placebo (-11.3%) and candesartan (-11.0%) groups. During the first 2 years, hypertension developed in 162 placebo and 53 candesartan participants (relative risk reduction [RRR], 68%; P < .001; original report 66%; P < .001). After 4 years, hypertension occurred in 197 placebo and 165 candesartan participants (RRR, 18%; P < .009; original report 16%; P < .007). The new definition resulted in a lower incidence of hypertension, but the outcomes were remarkably similar with both definitions and confirmed our original findings.
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Stevo
authors.initials: S
authors.lastname: Julius
authors.forename: Niko
authors.initials: N
authors.lastname: Kaciroti
authors.forename: Brent M
authors.initials: BM
authors.lastname: Egan
authors.forename: Shawna
authors.initials: S
authors.lastname: Nesbitt
authors.forename: Eric L
authors.initials: EL
authors.lastname: Michelson