Consider The Evidence: Med/Peds Journal Roundup

April 22, 2006

Treating *Pre*-Hypertension with ARBs

Filed under: hypertension, NEJM — medblog @ 7:16 am

NEJM – As the benefits of normotension have become clear, the JNC guidlines defining high blood pressure have become more aggressive. The latest revision created a pre-hypertension category of increased risk, in order to stress preventetive measures.

With a high rate of pre-hypertensive patients progressing to hypertension, would medical treatment prevent this change? In the first major study to explore such an option, the latest New England published a article by Julius, et al. testing whether it was feasible to treat pre-hypertension with candesartan.

722 patients with pre-hypertension, tested over three weekly readings, were included in the study. The subjects were randomized to ARB (16mg of candesartan) or placebo. The placebo-control period was two years, followed by a 2 year phase in which all subjects recieved placebo.

During the treatment period 154 pts in the placebo group developed HTN, but only 53 in the candesartan group – a 66% reduction. After the treatment period was over, there was still a 15% risk reduction for the group that had been on the ARB.

Should treating pre-HTN with medication become standard treatment? This study seems to support that conclusion.

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1 Comment »

  1. What will you advise for treatment of depression? In fact it is very dangerous, when depression passes in the chronic form. WBR LeoP

    Comment by John Medicine — February 2, 2007 @ 11:16 pm


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