Key result
Candesartan reduced the incidence of hypertension in patients with prehypertension by 66.3% at 2 years and 15.6% at 4 years.
Why the study?
Does candesartan 16 mg prevent or postpone the development of hypertension in patients with prehypertension?
RCT
Does candesartan 16 mg prevent or postpone the development of hypertension in patients with prehypertension?
Pharmacologic intervention with candesartan in prehypertensive patients can significantly delay the onset of clinical hypertension.
Answers are grounded in this paper and cite their sources.
May support ARB use to delay hypertension onset; hypothesis-generating Level 5 evidence leaves open need for outcome trials.
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.
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Shawna D. Nesbitt (2006) conducted an RCT in prehypertension. candesartan vs. placebo was evaluated on development of hypertension (66.3% relative reduction). Candesartan reduced the incidence of hypertension in patients with prehypertension by 66.3% at 2 years and 15.6% at 4 years.
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