Cardiovascular disease (CVD) is a leading contributor to morbibity and mortality in the United States and other contries. Treatment of high BP provides an established means of reducing morbidity and mortality rates from CVD. However, successful treatment of established hypertension reduces but does not eliminate the risks associated with hypertension. To achieve the broad goal of eliminating all BP related morbidity and mortality due to CVD, the treatment of hypertension may need to be complemented by equally vigorous efforts to prevent its development and to lower the BP of individuals with an average BP above the optimal level but not yet classified as hypertensive. This study, in patients 35 to 60 years old, whose blood pressure is between 130 mm Hg systolic and/or 85 mm Hg to 89 mm Hg diastolic, to determine if pharmacologic treatment with an angiotension II receptor (ARB) will reduce the incidence of progression to clinical hypertension (>140 mm Hg and/or>90 mm Hg). Patients will be randomized to either candesartan cilexetil of progression or placebo for an initial 2 year period followed by a second 2 year period of placebo for all patients. Patients participation will total 4 years.
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