[Significance of treating prehypertension with an angiotensin-receptor blocker--results from TROPHY study]

Prehypertension is considered a precursor of stage 1 hypertension and a predictor of excessive cardiovascular risk. TROPHY study investigated whether pharmacologic treatment of prehypertension prevents or postpones stage 1 hypertension. Treatment of prehypertension with angiotensin receptor blocker (ARB): candesartan monotherapy decreased incident hypertension in participates in the study. On the other hand, DHyPP study investigated whether early treatment with an ARB in young normotensive off spring of hypertensive parents persistently lowered blood pressure after treatment withdrawn, a possibility supported the animal study and found no persistent effect on blood pressure when treatment was withdrawn. Thus these studies have demonstrated the feasibility of treating prehypertension with an ARB, but inconsistent results of the persistent effect on blood pressure when treatment was withdrawn. Thus additional studies will be needed to ascertain whether this or other strategies involving early pharmacologic treatment of prehypertension would positively affect clinical outcomes as well as blood pressure.