TROPHY study: Outcomes based on the Seventh Report of the Joint National Committee on Hypertension definition of hypertension

Stevo Julius, Niko Kaciroti, Brent M. Egan, Shawna Nesbitt, Eric L. Michelson

Research output: Contribution to journalArticle

29 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)39-43
Number of pages5
JournalJournal of the American Society of Hypertension
Issue number1
StatePublished - Jan 1 2008



  • Prehypertension
  • candesartan
  • clinical trials
  • placebo

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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