Treating Prehypertension

To the Editor: The study by Julius et al. of the efficacy of candesartan for prehypertension (April 20 issue) 1 demonstrates what seemed obvious: if patients with prehypertension receive hypotensive drugs, arterial hypertension will develop in fewer of them because they are already being treated. This prediction was borne out in the study, but as compared with placebo, candesartan did not reduce cardiovascular events during the study period. The question is, does the administration of a hypotensive drug at a fixed dose reduce the cardiovascular morbidity and mortality in patients with prehypertension, as compared with the use of nonpharmacologic treatment and . . .